Onsite Personnel COVID-19 Checklist

If you are an on-site employee, please use this COVID-19 Daily Self Checklist each day before reporting to work. 

The US Centers for Disease Control and Prevention (CDC) recently added new symptoms to its known COVID-19 symptoms. We have added these new symptoms to the COVID-19 Daily Self Checklist. The updated checklist now has eleven (11) questions and if you answer YES to any of the questions, you MUST STAY HOME, notify your supervisor and call or email the COVID-19 HR Response Team.

The updated Checklist can be downloaded here and copies will also be available at your workplace.  The Checklist is also available on the MyUMass App, that you can download for free onto your smartphone.

Download, print and circulate the Checklist below. The checklist is being distributed and used to promote the University's response to the COVID-19 pandemic and to promote employee and campus safety. Place the checklist and the reminder posters in your work spaces, on campus and at home. You can help You and Your UMass Community stay safe. Checklists are also available in Spanish, Chinese, Vietnamese and Nepalese.

COVID-19 Daily Self-Checklist

  • Do you have a Fever (temperature over 100.30F) without having taken any fever reducing medications?
  • Do you have a Loss of Smell or Taste?
  • Do you have a Cough?
  • Do you have Muscle Aches?
  • Do you have a Sore Throat?
  • Do you have Shortness of Breath?
  • Do you have Chills?
  • Do you have a Headache?
  • Have you experienced any gastrointestinal symptoms such as nausea/vomiting, diarrhea, loss of appetite?
  • Have you, or anyone you have been in close contact with been diagnosed with COVID-19, or been placed on quarantine for possible contact with COVID-19?
  • Have you been asked to self-isolate or quarantine by a medical professional or a local public health official?

If you reply YES to any of the questions in the checklist, stay home (with pay) and follow the steps below:

  1. Call your supervisor and
  2. Call or Email the COVID-19 HR Response Team at 413-687-2283 or COVID19HR@umass.edu.

If you start feeling sick during your shift, follow steps 1 and 2 above.

Reminder Poster

Download this Checklist Reminder Poster to place both at work and at home.

COVID-19 Daily Self-Checklist English