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COVID-19 Screening Form-PDF Fillable (HYBRID-Digital/Printable) eSignature! Eco Friendly


Screen all home care employees who enter to visit seniors with this COVID-19 form. Simply send this form to employees before a shift, and have them quickly and easily digitally fill out, and then send back to you to file. If the department of health has questions about a possible outbreak and your workers were present, you will be able to quickly provide information.

This template is perfect for:

⭐ Home Care Company / Home Health Care Agency/ Senior care Business / Elder care Business
⭐ Family hiring a caregiver
⭐ Private / Independent Caregivers
⭐ 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 – ADOBE PDF Fillable Form (HYBRID-use both printed or digital format)
✔️ Formatting will not change when information is entered in fields
✔️ Fill out form digitally/manually
✔️ Digital Signature
✔️ Send electronically
✔️ Printable 🖨️

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

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New! Easy to use PDF Fillable COVID-19 Screening Form

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

covid-19 screening form-care workers-PDF Fillable-preview

digital signature

Fully customizable WORD option as well in the SHOP

covid-19 visit senior screening form template (1)




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