USA Industries Visitor Questionnaire

Visitor Questionnaire - Covid19
Estimated Time of Arrival *
Used to send visitor confirmation email of survey responses.
So we can reach visitor in case of change of plans.

VISITOR / CONTRACTOR HEALTH DECLARATION


I am a confirmed case of COVID-19 (Corona Virus) *
In the last 14 days - I have had close contact with a confirmed case of COVID-19 *
In the last 14 days - I have had close contact with someone who has returned from ANY International destination *
Have you had close ontact with or cored for someone diagnosed with COVID-19 within the last 14 days? *