Template: Printable Test Day Sheet with Symptoms



-228600889000Template: Printable Test Day Sheet with SymptomsInstructions: Use this sheet to plan for and track COVID-19 PPS testing.Test Date: _________________________________List for: ? Residents ? StaffNameDOBUnitRoomConsentSymptomsNotes? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Other? Agree? Refuse? Cough ? SOB ? Sore throat? Fever/feverish ? Otherhealth. | 06/24/2020 ................
................

In order to avoid copyright disputes, this page is only a partial summary.

Google Online Preview   Download