Fillable COVID-19 Response Team COVID-19 Statement of College Employee (Schenectady County Community College)

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COVID-19 Response Team COVID-19 Statement of College Employee (Schenectady County Community College)

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COVID-19 Response Team
COVID-19 Testing Pool Employee Return Opt-out Form 1 | Page
COVID-19 Statement of College Employee COVID-19 Pool Testing
Employee Name: ________________________________________________________________
Employee Sign: ________________________________________________________________
Department: ________________________________________________________________
Date: ________________________________________________________________
Supervisor: ________________________________________________________________
☐ Please be advised that I do not wish to participate, on a bi-weekly basis, in the
COVID-19 Pool Testing Program.
Please complete this form, and email it to Employeescovid19@sunysccc.edu
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COVID-19 Response Team COVID-19 Statement of College Employee (Schenectady County Community College)

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Completed 3 February 2021

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