Fillable Temperature Log~ Return to Work/School (University of Nebraska, Kearney)

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Temperature Log~ Return to Work/School (University of Nebraska, Kearney)

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Temperature Log~ Return to Work/School
Please use this log to monitor your temperature during isolation/quarantine. Provide this log to UNK Student Health
or your medical provider with the Medical Clearance form to obtain permission to return to work/class at UNK.
DATE
TIME
Temperature
~take twice a day
Notes/Symptoms
Day 1
Day 2
Day 3
Day 4
Day 5
Day 6
Day 7
Day 8
Day 9
Day 10
Day 11
Day 12
Day 13
Day 14
I certify that this information is true. I know this information will be used to obtain medical clearance from UNK Student
Health.
Print name:______________________________ Signature______________________________ Date _______________
NUID#:_________________________________
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Temperature Log Return to WorkSchool (University of Nebraska, Kearney)

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Completed 2 February 2021

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