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Allied Pre-Screening Self-Assessment Form

To provide a safe and healthy work environment, we want to make sure that we screen people accessing Allied, facilities, jobsites and offices for people exhibiting signs or symptoms of COVID-19. These signs may include dry cough, fever, and difficulty breathing. All allied personnel Accessing, facilities, jobsites and office is required to complete a self-assessment. To help protect you and those around you, please answer these questions truthfully to the best of your knowledge.


 
   Fever
   Shortness of Breath
   Dry Cough