To comply with safety standards to protect clients, employees, and involved others, we require that employees, clients, and those who reside with the client are symptom-free. Please complete and submit this form on days that clients and employees work together.
You must answer “NO” to all the questions in this questionnaire for an employee to work with the H.A.T.C.H. client. If you answer “YES” to any of the questions, please DO NOT allow the H.A.T.C.H. employee to enter the client's home or to have them work with the client.
If anyone who resides with the client experiences any symptoms or answer “YES” to any of these questions, you must immediately contact your health care professional for recommended next steps AND H.A.T.C.H.