COVID-19 Mandatory Weekly Testing Log Logo
  • COVID-19 Mandatory Weekly Testing Log

  • Instructions:

    All employees who are not fully vaccinated as defined by the Centers for Disease Control and do not have an approved testing exemption are required to participate in mandatory weekly Covid-19 testing. All testing should be conducted no more than 24 hours prior to the start of the employee's first shift of the administrative work week (Saturday 12:01 a.m. until the following Saturday 12:00 a.m.). Please accurately complete all sections on the form and upload your test results. Failure to complete mandatory weekly Covid-19 testing may result in disciplinary action.
  • Covid-19 Test Results

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  • I certify that the foregoing information is true and correct. I understand that a knowing and willful false statement on this form, failure to complete this form, or failure to comply with safety requirements related to COVID-19 including testing or vaccination program directives may lead to disciplinary action up to and including dismissal.

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