COVID-19 Daily Attestation | Zachariah Heiden Group | Washington State University

Washington State University

^{Department of Chemistry} _{Zachariah M. Heiden Group}

To prevent the spread of COVID-19, all students must complete a Daily Attestation prior to attending work:

Name*
Date*
Date Format: MM slash DD slash YYYY
Since your last day of work, please attest that you have not had any of the following conditions:*
- Select All
- Temperature at or above 100.4 degrees or reason to be concerned that a fever is developing
- New cough
- New chills
- New muscle aches
- New sore throat
- New shortness of breath or difficulty breathing
- Had close contact without the use of some PPE to someone who is sick with suspected or confirmed COVID-19 within the last 14 days
All of the boxes must be checked to attend work. If one or more boxes are not checked, the employee must stay home, inform Dr. Heiden, and/or seek medical attention.