BFC Daily Health Screening Questionnaire

Your health and safety is our primary concern as we re-open our offices.  If you are sick, please stay home.  If you become ill at work, please go home.

As part of our plan for re-opening our offices during the COVID-19 pandemic, you must review and complete this form each day you plan to enter our offices (regardless of how long you plan to be in our offices).  You may only come to the office if all of the following statements are true:


  • Date Format: MM slash DD slash YYYY







    • Cough*
    • Shortness of breath or difficulty breathing
    • Fever – 100.4° F (38.0° C) or more
    • Chills
    • Muscle pain
    • Sore throat
    • New loss of taste or smell
    • Gastrointestinal symptoms such as nausea, vomiting or diarrhea

    *Note: Coughing (or other symptoms) that are related to seasonal allergies are not considered symptoms of COVID-19.