Good Morning!

Please complete the following form each work day - answering 'YES' or 'NO' to each screening question - BEFORE entering either Mid-Illini Branch. THANK YOU! 

Employee COVID-19 Self Screening

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input

Invalid Input