Updated Employee and Visitor Screening Forms

Please Note:  On May 4, 2021, this article was updated with the most recent Visitor Screening Tool for fully vaccinated individuals, which can be found here.

The Indiana Department of Health has issued new screening documents for fully vaccinated individuals to serve as infection control tools for long-term care facilities. The Employee Screening Tool for fully vaccinated individuals can be found here, and the Visitor Screening Tool for fully vaccinated individuals can be found here.

The original Employee Screening Tool for unvaccinated individuals can be found here, and the original Visitor Screening Tool for unvaccinated individuals can be found here.