DRIVER HEALTH & SAFETY PRECAUTIONS
Reservation number
*
Driver name
*
Do you have a fever ?
*
Yes
No
Do you have shortness of breath ?
*
Yes
No
Do you have a cough ?
*
Yes
No
Are you wearing a mask ?
*
Yes
No
Are you wearing gloves ?
*
Yes
No
Was this vehicle being sanitized with disinfectant in between jobs (Lysol , Disinfectant spray) ?
*
Yes
No
Please upload a selfie with your mask and gloves
*
Does your Vehicle have a divider take a photo
*
By clicking YES and SUBMIT, you hereby confirm that this information is accurate, truthful, and you are following CDC guidelines. If you are not feeling well or do not agree to these safety precautions select NO and please inform BLS dispatch.
Yes
No
Submit
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