Daily Health Screening

As part of MBL’s Reopening Plan and MA State guidance, we ask that each day prior to coming to campus or taking part in MBL activities, you review the following questions.   Although this form is not required to be submitted to MBL, we appreciate your diligence on this task for an added level of safety for you as well as members of the MBL community.

1. Have you experienced any of the following symptoms in the past 48 hours?

  • Cough
  • Shortness of breath or difficulty breathing
  • Fever or chills
  • Fatigue
  • Muscle or body aches
  • Headache
  • Sore throat
  • New loss of taste or smell
  • Nausea or vomiting
  • Congestion or runny nose
  • Diarrhea

If experiencing ANY of the above symptoms, then report this information to your supervisor or MBL point of contact immediately.  These symptoms may be related to COVID-19 and may require you to stay at home or in a designated MBL housing location.   If any of these symptoms continue, please contact your primary care doctor. In some cases, it may be necessary to self-quarantine for 10 days and thus you are not permitted to take part in MBL activities or enter any MBL facilities during that time.  If a doctor confirms that the cause of your symptoms is not COVID-19 related and provides a written release or provides a negative PCR test result to Human Resources; then you are no longer are required to quarantine.

2. Have you recently traveled outside the state of Massachusetts to a state not included in the Commonwealth of Massachusetts COVID-19 lower-risk state exemption list?

  • Yes
  • No

If answered YES, you may need to remain out of MBL facilities for fourteen (14) days upon returning from travel or have proof of a negative PCR test result for COVID-19 from a test administered within 72 hours of arrival in Massachusetts. Please check with your supervisor or MBL point of contact to determine if your travel situation requires you to remain out of campus facilities.

3. Have you recently been exposed to anyone that is experiencing symptoms related to COVID-19 or has tested positive for COVID-19 (within 6 feet of distance or for longer than 15 minutes over a 24 hour period)?

  • Yes
  • No

If answered YES, you must report this information to your supervisor or MBL point of contact immediately, and you may need to: self-quarantine for 7 days showing no symptoms with a negative PCR test taken day 5 or later, self-quarantine for 10 days showing no symptoms, or quarantine until the individual experiencing symptoms has shown to be negative for COVID-19.

Thank you for your adherence to this daily self-health screening and for following the below protocols!

  • Maintaining a physical distance of at least six feet whenever possible when I am with others (or at least eight feet when eating or drinking indoors),
  • Wearing a face mask at all times, unless enclosed in an office or when outside in designated break areas and able to maintain a safe social distance from others,
  • Washing my hands with soap and water frequently for at least 20 seconds, or using alcohol-based hand sanitizer when soap and water is not available, throughout the day and before and after in-person interactions with others, and
  • Using disinfecting wipes or spray provided throughout campus and other MBL facilities to clean surfaces with which I come into contact, including but not limited to desks and other working spaces.