COVID-19 Employee Return to Work - Needs Survey
For use by employees who cannot use a face mask. Limited
Recommended for use by employees accepting materials from
For daily self-cleaning of personal workstations.
For use when frequent hand washing is not an option.
Work stations must be 6' apart from each other.
When scheduling of shared offices that do not
permit social distancing cannot be worked out
For installation in areas with high levels of person-
to-person contact occur
To encourage 6' distancing in high traffic areas
Upon completion Form will be sent to Facilities for creation of a work order.