COVID-19 Screening Survey

The safety of our employees, customers, suppliers, partners and other third parties has also been an important part of our principles at Creative Foam. Now, more than ever, it is critical to ensure we uphold this belief by protecting those which we value so much. Due to the global COVID-19 pandemic, Creative Foam is constantly looking at how to perform those actions which will continue to provide the proper protection to all and to ensure we operate in accordance with guidance from the Centers for Disease Control (CDC) and Prevention and the World Health Organization (WHO). As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve and spreads globally, Ford Medical and Security are monitoring the situation closely and will periodically update company guidance based on current recommendations from the Centers for Disease Control and Prevention and the World Health Organization.

Based on the available information and and guidance received, older adults and those of any age with any serious underlying medical conditions (such as heart disease, lung disease, asthma, immunocompromised, liver disease, etc) are likely to be at higher risk for severe illness from COVID-19. If you are concerned about your situation with regard to those conditions, please contact your personal medical health care provider before returning to work.

To keep everyone safe and reduce the potential risk of exposure to our workforce, as well as comply with recommendations from state and local authorities, Creative Foam is conducting a simple screening process. Your participation is mandatory and integral in helping us to take the correct steps to protect everyone within the facilities we operate. Prior to entering a facility, you must complete the screening survey which will inform you if you should return to work (if you are an employee) or if you are allowed to enter (if you are a third party / visitor). We appreciate your help in keeping everyone safe and stopping the spread of COVID-19.

(Note: You are NOT required to enter any personal information if you answer 'Yes' to any questions)

Please read each of the following 4 questions prior to answering below:

  1. Have you received a confirmed diagnosis for coronavirus (COVID-19) by a coronavirus (COVID-19) test or from a diagnosis by a health care professional in the past 14 days?
  2. Have you traveled by airplane internationally or domestically in the last 14 days?
  3. Have you had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days?
  4. Have you experienced any cold or flu-like symptoms in the last 14 days (to include: fever, cough, difficulty breathing, sore throat, pressure in the chest, extreme fatigue, earache, persistent headache, diarrhea, and persistent loss of smell or taste)?

If you are able to answer 'Yes' to one or more of the above questions, please select 'Yes' below. Please select 'No' ONLY if you are able to answer all above questions with 'No.'

The information provided by you will only be used by Creative Foam for the purposes of providing access to the facility and managing business operations.