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COVID-19 Health Screening Web
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With Mountain Stream Theme
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"Health Screening Web Form"

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COVID-19 Health Screening Web Form Template

COVID-19 Health Screening Web is an essential tool for organizations prioritizing health and safety. This comprehensive form enables easy health assessment, ensuring individuals are screened for COVID-19 symptoms, recent contacts, and travel history. Seamlessly integrated into your website, this secure form showcases your commitment to public health compliance and safety protocols.

Pairing the COVID-19 Health Screening Web with the Mountain Stream theme creates a serene and engaging user experience. With a tranquil light blue backdrop, large inputs, and mountain blue buttons, this theme exudes clarity and calmness. Enhance your form's visual appeal and user interaction with Mountain Stream, setting a peaceful tone for health assessments. Ready to streamline your health screening process? Get started with COVID-19 Health Screening Web and Mountain Stream today!

Get Started Using This Form Template

COVID-19 Health Screening Web Features

Streamline Health Assessments
Streamline Health Assessments
Efficiently collect critical health data with our user-friendly COVID-19 Screening Form.
Ensure Compliance & Safety
Ensure Compliance & Safety
Demonstrate due diligence in safeguarding health with our secure and interactive form.
Enhance User Experience
Enhance User Experience
Immerse users in tranquility with the serene "Mountain Stream" theme for a calming interaction.
Engage with Large Inputs
Engage with Large Inputs
Guide users effortlessly through the form with large inputs for a seamless experience.
Drive Clarity with Dark Labels
Drive Clarity with Dark Labels
Enhance readability and clarity with dark labels for easy form navigation.
Optimize Health Checks
Optimize Health Checks
Effortlessly pre-screen patients, students, employees, and attendees with our essential form.
COVID-19 Health Screening Web Form Template
Customizable Form Fields
You can add, remove or re-arrange form fields when using our form builder app.
title (html-block)
title
fullName* (text, input)
Full Name
email* (email)
Email Address
phoneNumber* (phone-number)
Phone Number
symptoms* (boolean, buttons)
Have you experienced any COVID-19 symptoms in the last 14 days?
contact* (boolean, buttons)
Have you been in close contact with a confirmed or probable COVID-19 case?
travel* (boolean, buttons)
Have you traveled internationally in the last 14 days?
additionalInfo (text, textarea)
Additional Information

Try Out the Form for Yourself!

Experience Ease and Flexibility Across Multiple Devices and Screens

The form below is using our "Mountain Stream" form theme. You can change the colors and the theme using the Wizara Form Builder app.