To enable coronavirus contact tracing the biological station requires everyone to sign in and out of the station grounds. Full Name - or - UVA Computing ID (e.g. ekm9m) * Contact Information (cell, email, other) - or - you can SKIP this if using UVA Computing ID If you are you arriving or departing the station please indicate: * arriving departing Health Attestation, Positive Test and Contact Check, and Policy Compliance I attest that I am without symptoms such as new onset or worsening of shortness of breath, fever of 100.0 degrees or greater, or cough, not otherwise explained by a chronic medical issue. And, I confirm I have not tested positive for coronavirus, or been in contact with anyone ill with COVID or testing positive for coronavirus, in the past 14 days. I further attest to be in good health and capable of carrying out my job assigned duties safely. And, I agree to comply with the MLBS "COVID-19 Residential Policies and Procedures" posted here: https://mlbs.virginia.edu/sites/mlbs.virginia.edu/files/mlbs-covid19-residential-policy.pdf IF YOU CAN NOT CHECK THIS BOX: Do not enter the station property or buildings without clearance from station personnel. Call 540-626-7196 or email MLBS@virginia.edu. Inform your supervisor of your symptoms. UVA employees should call Employee Health at 434-924-2013 for further guidance. Time * Hour Hour123456789101112 : Minute Minute000510152025303540455055 am pm Date * Month MonthDecJan Day Day12345678910111213141516171819202122232425262728293031 Year Year20212022
