COVID-19 Health Screening
In an effort to reduce the risk of COVID-19 exposure to Greenville University employees, all visitors must complete the following screening questions. After completing this form, all visitors are required to check in at Campus Safety. If visiting on Monday-Friday between 8am-4pm, then please come to Campus Safety to pick up a Visitor's Badge. If visiting outside of normal business hours, then please call 618-664-7777 to receive verbal confirmation. The Campus Safety Office is located at 416 N. Elm Street, Greenville, IL 62246.
Date
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Month
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Day
Year
Date
Name
First Name
Last Name
Email
example@example.com
Phone Number
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Area Code
Phone Number
Are you an employee of Greenville University?
Yes
No
Are you a guest or visitor to GU's campus?
Yes
No
If you are a guest or visitor, what is your date of visit to Greenville University's Campus?
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Month
-
Day
Year
Date
Person/Department Visiting:
1. Have you traveled out the United States or recently traveled to an area in which community spread or ongoing spread of COVID-19 is present?
Yes
No
2. Have you been in close contact with or cared for someone diagnosed with COVID-19 within the last 14 days?
Yes
No
3. Have you experienced any cold or flu-like symptoms in the last 14 days (fever, cough, shortness of breath or other respirator problem)?
Yes
No
Greenville University is requiring all employees, students, guests and visitors to adhere to the guidelines and recommendations set forth by the CDC, IDPH and Bond County Health Department in practicing social distancing guidelines, healthy hand washing practices and the use of face coverings when social distancing guidelines cannot be met. Do you understand and agree to follow the required guidelines as outlined?
Yes
No
Visitors answering yes to questions 1-3 will not be permitted to access Greenville University's campus. If you have any questions, please contact the Office of Human Resources at (618) 664-6845. Please leave any comments or concerns in the text box below.
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