As we progress through this pandemic, it is important that we do everything possible to slow and stop the spread of COVID-19. This questionnaire and the guidelines within it are an important part of that effort. Your responses to this questionnaire and compliance with the guidelines are considered a Safety matter of utmost importance.
MCC COVID-19 Response Questionnaire
Are you experiencing any of the following symptoms?
- Fever (100.0℉ or greater)
- Cough
- Shortness of Breath or Difficulty Breathing
- Fatigue
- Flu-like Body Aches
- Headache
- Sore Throat
- New Loss of Taste or Smell
- Chills
- Repeated Shaking with Chills
- Nausea or Vomiting
- Diarrhea
Stay Home or Go Home
- If you are at work, call your supervisor and tell them you are going home immediately.
- Call the Safety Hotline (479-927-4218).
- Follow the screening process from one of the resources below or contact your medical provider.
- Online COVID-19 Screening
- U of A Medical Sciences: https://uamshealth.com/healthnow/
- Arkansas Department of Health Hotline: 1 (800) 554-5738
- Online COVID-19 Screening
- Mercy: https://www.mercy.net/service/covid-19/
- Missouri Department of Health Hotline: 1 (877) 435-8411
Were you instructed to test for COVID-19?
Stay Home
Wait until test results are received.
Call the Safety Hotline (479-927-4218).
Did you test positive for COVID-19?
Stay Home
Follow your medical provider's directions.
Call the Safety Hotline (479-927-4218) and inform them of your test result.
Doctor authorization is required to return to work.
Stay Home
Get a medical provider's release, or wait 24 hours after your fever breaks.
Call the Safety Hotline (479-927-4218) before returning to work.
Stay Home
Get a medical provider's release, or wait 24 hours after your fever breaks.
Call the Safety Hotline (479-927-4218) before returning to work.
Have you had close contact with someone who tested positive for COVID-19 in the last 14 days?
Stay Home or Go Home
- If you are at work, call your supervisor and tell them you are going home immediately.
- Call the Safety Hotline (479-927-4218).
- Quarantine yourself away from others for 14 days since your last contact with the person that tested positive for COVID-19.
Call the Safety Hotline (479-927-4218) before returning to work.
Important: If you start developing any symptoms, you need to retake this questionnaire.
Have you had close contact with someone while they were experiencing any of the following symptoms?
- Fever (100.0℉ or greater)
- Cough
- Shortness of Breath or Difficulty Breathing
- Fatigue
- Flu-like Body Aches
- Headache
- Sore Throat
- New Loss of Taste or Smell
- Chills
- Repeated Shaking with Chills
- Nausea or Vomiting
- Diarrhea
Is the affected person a member of your household or someone that you provide care for?
Stay Home
Follow the affected person's medical provider's instructions.
Call the Safety Hotline (479-927-4218).
Did the affected person meet COVID-19 screening requirements?
Was the affected person instructed to test for COVID-19?
Stay Home
Wait until test results are received.
Call the Safety Hotline (479-927-4218).
Did the affected person test positive for COVID-19?
Stay Home or Go Home
- If you are at work, call your supervisor and tell them you are going home immediately.
- Call the Safety Hotline (479-927-4218).
- Quarantine yourself away from others for 14 days since your last contact with the person that tested positive for COVID-19.
Call the Safety Hotline (479-927-4218) before returning to work.
Important: If you start developing any symptoms, you need to retake this questionnaire.
Return to Work
Take steps to protect yourself and others.
- Practice Social Distancing
- Maintain a distance of at least 6 feet from others
- Avoid crowded places or gatherings
- Avoid contact with people who are sick
- Wash your hands often for at least 20 seconds
- Avoid touching your eyes, nose, and mouth with unwashed hands
- Cover coughs and sneezes with a tissue or use the inside of your elbow
Important: If you start developing any symptoms, you need to retake this questionnaire.
Does the affected person have a fever from a contagious illness?
Stay Home
Get a medical provider's release, or wait 24 hours after the affected person's fever breaks.
Call the Safety Hotline (479-927-4218).
Important: If you start developing any symptoms, you need to retake this questionnaire.
Return to Work
Take steps to protect yourself and others.
- Practice Social Distancing
- Maintain a distance of at least 6 feet from others
- Avoid crowded places or gatherings
- Avoid contact with people who are sick
- Wash your hands often for at least 20 seconds
- Avoid touching your eyes, nose, and mouth with unwashed hands
- Cover coughs and sneezes with a tissue or use the inside of your elbow
Important: If you start developing any symptoms, you need to retake this questionnaire.
Does the affected person have a fever from a contagious illness?
Stay Home
Get a medical provider's release, or wait 24 hours after the affected person's fever breaks.
Call the Safety Hotline (479-927-4218).
Important: If you start developing any symptoms, you need to retake this questionnaire.
Return to Work
Take steps to protect yourself and others.
- Practice Social Distancing
- Maintain a distance of at least 6 feet from others
- Avoid crowded places or gatherings
- Avoid contact with people who are sick
- Wash your hands often for at least 20 seconds
- Avoid touching your eyes, nose, and mouth with unwashed hands
- Cover coughs and sneezes with a tissue or use the inside of your elbow
Important: If you start developing any symptoms, you need to retake this questionnaire.
Was the affected person instructed to test for COVID-19?
Stay Home
Wait until test results are received.
Call the Safety Hotline (479-927-4218).
Did the affected person test positive for COVID-19?
Stay Home or Go Home
- If you are at work, call your supervisor and tell them you are going home immediately.
- Call the Safety Hotline (479-927-4218).
- Quarantine yourself away from others for 14 days since your last contact with the person that tested positive for COVID-19.
Call the Safety Hotline (479-927-4218) before returning to work.
Important: If you start developing any symptoms, you need to retake this questionnaire.
Return to Work
Take steps to protect yourself and others.
- Practice Social Distancing
- Maintain a distance of at least 6 feet from others
- Avoid crowded places or gatherings
- Avoid contact with people who are sick
- Wash your hands often for at least 20 seconds
- Avoid touching your eyes, nose, and mouth with unwashed hands
- Cover coughs and sneezes with a tissue or use the inside of your elbow
Important: If you start developing any symptoms, you need to retake this questionnaire.
Continue Working
Take steps to protect yourself and others.
- Practice Social Distancing
- Maintain a distance of at least 6 feet from others
- Avoid crowded places or gatherings
- Avoid contact with people who are sick
- Wash your hands often for at least 20 seconds
- Avoid touching your eyes, nose, and mouth with unwashed hands
- Cover coughs and sneezes with a tissue or use the inside of your elbow
Important: If you start developing any symptoms, you need to retake this questionnaire.
Have you traveled internationally / between US territories?
Stay Home
Call the Safety Hotline (479-927-4218).
You are required to get tested 3-5 days after travel. Wait until test results are received.
Did you test positive for COVID-19?
Stay Home
Follow your medical provider's directions.
Call the Safety Hotline (479-927-4218) and inform them of your test result.
Doctor authorization is required to return to work.
Stay Home
Call the Safety Hotline (479-927-4218) and inform them of your test result.
Quarantine yourself away from others until 7 days after traveling.
Important: If you start developing any symptoms, you need to retake this questionnaire.
Continue Working
Take steps to protect yourself and others.
- Practice Social Distancing
- Maintain a distance of at least 6 feet from others
- Avoid crowded places or gatherings
- Avoid contact with people who are sick
- Wash your hands often for at least 20 seconds
- Avoid touching your eyes, nose, and mouth with unwashed hands
- Cover coughs and sneezes with a tissue or use the inside of your elbow
Important: If you start developing any symptoms, you need to retake this questionnaire.