Prince George's County Government, Maryland
Daily Wellness Self-Screening Form
Thursday, March 28, 2024
To prevent the spread of COVID-19 and reduce the potential risk of exposure to our workforce and visitors, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone in this building. Thank you for your time.
Screening Questionnaire
*
Are you a Prince George's County Employee?
Yes
No
Your Employee ID is located on your County badge.
Are you a Contractor/Temp?
Yes
No
Select Agency:
* Agency
Central Services
Circuit Court
Clerk of the Circuit Court
Community Relations
Corrections
County Council
County Executive
Environment
Elections
Ethics and Accountability
Family Services
Finance
Fire/EMS
Health
Homeland Security
Housing & Community Development
Housing Authority
Human Relations
Human Resources Management
Information Technology
HHS Portal
Law
License Commissioners
Management & Budget
OCS
Permitting, Inspections and Enforcement
Police
Public Works & Transportation
Redevelopment Authority
Revenue Authority
Sheriff
Social Services
State's Attorney
Prince George's County Public Schools
Prince George's County Memorial Library System
Maryland-National Capital Park & Planning Commission
Personnel Board
*
Have you experienced any of the symptoms listed below in the past 48 hours?
(not related to pre-existing conditions such as: Asthma or Seasonal Allergies)
Yes
No
Symptoms list: Fever or chills, Cough, Shortness of breath or difficulty breathing, Fatigue, Muscle or body aches, Headache, New loss of taste or smell, Sore throat, Congestion or runny nose, Nausea or vomiting, Diarrhea
*
Within the past 14 days, have you been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have laboratory-confirmed COVID-19 or with anyone who has any symptoms consistent with COVID-19?
Yes
No
*
Are you currently isolating because you have tested positive for COVID-19?
Yes
No
*
Are you currently quarantining because you have been exposed to someone who has tested positive for COVID-19 or has symptoms of COVID-19?
Yes
No
*
Are you currently waiting on the results of a COVID-19 test?
Yes
No
Email Address
Please Note: For In and Out access throughout the day, please enter your email address. You will receive an email with your daily access status, which you can show upon re-entering the building for the day. (Access expires daily)