How To Complete The Occupational Health COVID- 19 Screening Form
How to Complete the Occupational Health COVID-19 Screening Form1.1The Occupational Health Online Screening form isrequired of anyone who answered Yes to either Question2 or 3 in the UTSW Protect Daily Screening Tool.Access the UTSW Protect daily screening tool by clickinghere: UTSW Protect.Access the Occupational Health form by clickingOccupational Health COVID-19 Screening Tool.The steps in this Tip Sheet will help you complete theOccupational Health form, not the UTSW Protect tool.1.2As with the initial screening questions, please answerall questions honestly and appropriately.In Question 1, please identify the primary reason youare completing the COVID-19 Screening form today.
How to Complete the Occupational Health COVID-19 Screening Form1.3For Question 2, please acknowledge your agreement thatOccupational Health may need to share certain healthinformation about you with other occupational healthprofessionals, depending upon your responses.Questions 3-6 should be self-explanatory. Enter your Firstand Last Name, your date of birth (mm/dd/yyyy) andyour UT Southwestern ID in the requested fields.
How to Complete the Occupational Health COVID-19 Screening Form1.4For Question 7, please enter a valid mobile number inwhich you may receive texts and/or phone calls.For Question 8, please enter your UT Southwestern emailaddress. If you do not have one, please list your primaryemail address.In Question 9, please list your supervisor’s first and lastname.In Question 10, please select your appropriate role fromthe list provided. NOTE Depending upon your response,you may be asked additional questions related to yourrole.Additionally, depending upon how you respond tospecific questions, the Question Numbers from this pointforward might be different from those listed in this TipSheet.For Question 11, please provide a specific location forwhere you primarily work on campus.
How to Complete the Occupational Health COVID-19 Screening FormNOTE: Depending upon how you respond to specificquestions, the Question Numbers might be differentfrom those listed in this Tip Sheet.1.5Please identify your patient care responsibility, ifapplicable. Depending upon your response, furtherscreening questions might be required.For Question 12, please state whether or not you havealready been tested for COVID-19.For Question 13, please indicate if you are experiencingany symptoms associated with COVID-19.Question 14 helps identify whether you have come intocontact and/or been exposed to anyone in the past 14days, personally or professionally, with COVID-19.For Question 15, please acknowledge yourunderstanding that it is your responsibility to notifyOccupational Health if you are the caregiver or livingwith a person who has a pending COVID-19 test.
How to Complete the Occupational Health COVID-19 Screening FormNOTE: Depending upon how you respond to specificquestions, the Question Numbers might be differentfrom those listed in this Tip Sheet.1.6For Question 17, please identify whether or not you havetravelled internationally in the last 14 days.For Question 18, if you did travel internationally, pleaselist all locations that you visited.For Question 19, please indicate when you arrived in theinternational location (mm/dd/yyyy).For Question 20, please indicate when you returned fromthe international location (mm/dd/yyyy).For Question 21, please indicate whether you traveled bycruise or riverboat in the last 14 days.
How to Complete the Occupational Health COVID-19 Screening FormNOTE: Depending upon how you respond to specificquestions, the Question Numbers might be differentfrom those listed in this Tip Sheet.1.7For the questions related to COVID-19 Testing, pleaseindicate:-Your willingness to be referred for COVID-19 testing,regardless of whether you are currently showingsymptoms or not.-Your acknowledgment that you voluntarily authorizeOccupational Health to share your test results andother health information securely via your email.-Your race (you may select one or more).
How to Complete the Occupational Health COVID-19 Screening FormNOTE: Depending upon how you respond to specificquestions, the Question Numbers might be differentfrom those listed in this Tip Sheet.1.8For the questions related to COVID-19 Testing, pleaseindicate:-Your ethnicity (you may select one or more).-Your gender.1.9At this point, you have successfully completed yourOccupational Health COVID-19 Screening Form.Please check your Inbox for additional information.Depending upon your responses to the questions withinthe form, you may be contacted by Occupational Healthfor additional questions. Your prompt attention to themis greatly appreciated.
How to Complete the Occupational Health COVID-19 Screening Form1.10Based upon your responses to the screening form, youwill receive a follow-up email from Occupational Health(two such examples are listed on this page).You are encouraged to read the emails closely andcomply with any instructions or requests within them.To contact Occupational Health directly, feel free to usethe contact information below:Work: 214-645-5300Fax: 214-645-5196WebsiteEmail
Access the Occupational Health form by clicking . Occupational Health COVID- 19 Screening Tool. The steps in this Tip Sheet will help you complete the Occupational Health form, not the UTSW Protect tool. How to Complete the Occupational Health COVID- 19 Screening Form. 1.2 As with the initial screening questions, please answer
May 02, 2018 · D. Program Evaluation ͟The organization has provided a description of the framework for how each program will be evaluated. The framework should include all the elements below: ͟The evaluation methods are cost-effective for the organization ͟Quantitative and qualitative data is being collected (at Basics tier, data collection must have begun)
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̶The leading indicator of employee engagement is based on the quality of the relationship between employee and supervisor Empower your managers! ̶Help them understand the impact on the organization ̶Share important changes, plan options, tasks, and deadlines ̶Provide key messages and talking points ̶Prepare them to answer employee questions
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Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. 3 Crawford M., Marsh D. The driving force : food in human evolution and the future.
