Fillable Employee Attestation Regarding COVID-19 (Anne Arundel Community College)

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Employee Attestation Regarding COVID-19 (Anne Arundel Community College)

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Updated 6/25/2020
Employee Attestation Regarding COVID-19
As on-site work restrictions are lifted by the Governor and County Executive, daily COVID-19 employee
symptom attestation is required of employees returning to their on-site work location to ensure the
safety and public health of the AACC campus and community.
These requirements apply to all staff and student employees who work on-site at an AACC work
location.
By signing below, I attest to the follow statements and will abide by college protocols regarding personal
protective equipment (PPE):
• I am currently asymptomatic without any of the following symptoms: cough, shortness of
breath, fever, chills, muscle pain, sore throat, new loss of taste or smell, nausea, vomiting or
diarrhea.
• I have had no known potential exposure to COVID-19. I understand that the definition of
potential exposure means being an intimate partner, housemate, or caregiver of, or having
unprotected close contact (less than 6 feet apart for 15 minutes or more) with an individual with
confirmed or suspected COVID-19. The timeframe for having contact with an infected individual
includes the period of time from 48 hours before the individual became symptomatic until they
meet CDC criteria for discontinuing home isolation.
• If at any point during my physical presence at any AACC location, I am not able to confirm the
above statements are still true, I will immediately report this change in health or exposure to the
college via COVIDsafety@aacc.edu, I will leave the AACC property immediately, notify my
supervisor, and will not come to any AACC location until I have met the guidelines for ending
self-quarantine per the CDC guidelines (https://www.cdc.gov/coronavirus/2019-ncov/hcp/
disposition-in-home-patients.html). I agree that by being present at any AACC location, I am
attesting that my conditions have not changed.
Signature
AACC ID
Name
Date
___________________________________________________
___________________________________________________
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Employee Attestation Regarding COVID-19 (Anne Arundel Community College)

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Completed 22 July 2020

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