COVID-19 Screener Form for Staff, Clients and Volunteers
Please note to all staff, clients, and volunteers:
Before entering WOCRC – 2 MacNeil Court, you must fill out the attached form and return the completed version to your supervisor.
- To download the form, click on the image below or click here for the 18 and older form
- To download the form, click on the image below or click here for the under 18 form
- The form will appear on your screen
- Right-click with your mouse and select “Save as” OR hover over the form and click “download” from the bar that appears at the top
- You can choose to rename the file if you wish
- Click Save
- Open the form using a program such as Adobe Reader or Adobe Acrobat
- Fill in the form and save it
- Send it to your supervisor via email
IF USING A SMARTPHONE: Please be sure to download the Adobe Reader app (FREE) on iOS or Android before filling out the form below.