COVID-19 Health Form-Professional Senior Care Template


Screen all home care employees who enter to visit seniors with this COVID-19 form. You can customize this form and enter your logo. This is a safe, fast, and eco-friendly option. If the department of health has questions about a possible spread of the virus, you will be able to quickly provide information regarding your caregiver employees.

This template is good for:

⭐ Home Care Company / Home Health Care Agency/ Senior care Business / Elder care Business
⭐ Family hiring a caregiver
⭐ Private / Independent Caregivers
⭐ Care Facility
⭐ Volunteer Group
⭐ Non-Profit Organization

How can this template help?

⭐ Protect the health of seniors
⭐ Better communication with care team
⭐ Accountability among staff and clients
⭐ Quick access to client information
⭐ Administrative uniformity
⭐ Repetition saves time and money

Main Features:

✔️ Master File- WORD
✔️ Easy to edit forms
✔️ Form fill digitally/manually
✔️ Print to PDF
✔️ Send electronically!
✔️ Printable form 🖨️

📥 Download, save master copies and start using the form immediately!


Visitor COVID-19 Health Form – Editable

covid-19 visit senior screening form template (1)

You also have the option to purchase this form already PDF formatted and easily have your care workers digitally fill and eSign and send back before a shift.

covid-19 screening form for care worker-pdf fillable form- HYBRID-digital and printable template













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