Fillable Return To Patient Care 5.6.20

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Return To Patient Care 5.6.20

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COVID-19 Daily Screening Log
DATE
NAME
TEMPERATURE
<100.4
°
F
COUGH
NEW
SHORTNESS OF
BREATH
ASKED TO GO HOME
(Note Time Dismissed)
Yes No
Yes No
Yes, Time: No
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Return To Patient Care 5.6.20

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Completed 24 December 2020

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