*Remington Park Daily Employee Health Screening*
****All Fields Required to be completed daily****
Name
*
First Name
Last Name
Department
*
Please Select
Accounting
Broadcast
Cage & Count
Catering
Club Remington
Compliance
Concessions
Executive
F&B Administration
Facility Maintenance
General Admin
Gift Shop
Group Sales
Human Resources
Information Technology
Marketing
Mutuels/OTB
Players
Racing
Racing F&B
Racing Publications
Safety & Compliance
Security
Silks
Slot Operations
Slot Technicians
Social Media
Surveillance
Track Maintenance
Warehouse
Other Dept Not Listed
Work Location Status
*
Please Select
Administrative Leave
Annual Leave
COVID-19 Leave (Tested + for Covid-19)
FMLA
Not on Schedule (Normal day off)
On-Call Status
On-site
Remote Status (Working remotely)
Self-Quarantine (Exposed to Covid-19)
Sick Leave (Not related to Covid-19)
How are you feeling today?
*
Normal
Not well
Temperature Reading
*
Have you had any of the following signs/symptoms within the last 24 hours:
Do you currently, or have you recently, had a cough?
*
Yes
No
Have you been experiencing any shortness of breath?
*
Yes
No
Have you been feeling unwell with cold/flu-like symptoms?
*
Yes
No
Have you had gastrointestinal symptoms (abdominal pain, nausea/vomiting, diarrhea)?
*
Yes
No
Have you recently experienced sudden loss of taste/smell?
*
Yes
No
Have you had direct exposure to any contacts with COVID-19 within the last 14 days?
*
Yes
No
Date
*
-
Month
-
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Submit
Should be Empty: