Crickler COVID-19 Screening | Crickler Vending Company

Name*

First Last

Are you a vendor/supplier (Not Crickler)?*

If you are not an employee at Crickler, select yes. If you are a Crickler employee, select no.

Yes
No

Company name

Crickler location*

Temperature:*

If your temperature is 99.5 or above, you must return home and wait until a manager reaches out to you with further instructions before returning to work.

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

Check all that apply.

Within the past 14 days, have you been in close physical contact with someone who is COVID positive or showing symptoms?*

Close physical distance would be 6 feet or closer for a cumulative total of 15 minutes in which one or both people were not wearing masks. -- Check all that apply.

Yes, someone who is known to have laboratory-confirmed COVID-19
Yes, someone who has symptoms consistent with COVID-19
No, have not been in contact with anyone who is covid positive or showing symptoms

Within the past 14 days, have you traveled outside NY to another state that is considered at high risk?*

Yes
No

Crickler Facilities COVID-19 Screening