This version of the form is not currently in use and is provided for reference only. Download this version of the document for the current year.
Screening Questionnaire for State Operated Offices & Facilities is a legal document that was released by the Maryland Department of Budget and Management - a government authority operating within Maryland.
Q: What is the purpose of the screening questionnaire for State Operated Offices & Facilities in Maryland?
A: The purpose of the screening questionnaire is to assess the health status of individuals entering State Operated Offices & Facilities in Maryland.
Q: Who needs to complete the screening questionnaire?
A: All individuals entering State Operated Offices & Facilities in Maryland need to complete the screening questionnaire.
Q: What information does the screening questionnaire collect?
A: The screening questionnaire collects information about symptoms, recent exposure to COVID-19, and recent travel history.
Q: Do I need to complete the screening questionnaire every time I enter?
A: Yes, individuals need to complete the screening questionnaire every time they enter State Operated Offices & Facilities in Maryland.
Q: What happens if I answer 'yes' to any of the screening questions?
A: If you answer 'yes' to any of the screening questions, you may be denied entry or referred for further evaluation.
Q: Can I refuse to complete the screening questionnaire?
A: Individuals who refuse to complete the screening questionnaire may be denied entry to State Operated Offices & Facilities in Maryland.
Q: Are there any exemptions to completing the screening questionnaire?
A: There are exemptions for certain individuals, such as those who have previously tested positive for COVID-19.
Q: How long is the screening questionnaire information retained?
A: The screening questionnaire information is retained for a period of 30 days.
Q: Is my personal information collected through the screening questionnaire protected?
A: Yes, personal information collected through the screening questionnaire is protected under HIPAA and other applicable privacy laws.
Form Details:
Download a printable version of the form by clicking the link below or browse more documents and templates provided by the Maryland Department of Budget and Management.