
COVID-19 Guidance Self
Certification
2020
Email: ______________________________
Supervisor: ______________________________
Date: ______________________________
Last Name: ______________________________
First Name: ______________________________
Company: ______________________________
By checking the box and completing the certificate, you certify that
you have completed this training and understand the safety guidance
provided.
Please complete the fillable certificate
Provide a copy to your employer.
Keep a copy for your record
Send a copy to SUNY Poly EHS using the following steps:
1. Click File -> Save As
2. Name your document and save it to your computer
3. Attach the file to an email and email it to:
SUNYPOLYEHS@SUNYPOLY.edu