Select Course
973.377.2039
Contact Us973.377.2039
Back to Home
COVID-19 Screening Protocol: Employee self-check of health
Please fill out this form before the beginning of your shift.
YES or NO since my last day of work have I had any of the following:

(If an employee answers YES to any of the screening questions before reporting to work, should not report to work. )
Name(Required)
Shift working:
A new fever (100.4°F or higher) or a sense of having a fever?(Required)
A new cough that cannot be attributed to another health condition?(Required)
New shortness of breath that cannot be attributed to another health condition?(Required)
New chills that cannot be attributed to another health condition?(Required)
A new sore throat that cannot be attributed to another health condition?(Required)
New muscle aches (myalgia) that cannot be attributed to another health condition or specific activity (such as physical exercise)?(Required)
A new loss of taste or smell?(Required)
A positive test for the virus that causes COVID-19 disease within the past 14 days?(Required)
Close contact (within about 6 feet for 15 minutes or more) with someone with suspected or confirmed COVID-19 in the past 14 days?(Required)
International travel in the past 14 days?(Required)
Copyright © 2021. Pinch Brook Golf Course. 234 Ridgedale Avenue, Florham Park, NJ 07932. 973.377.2039
Managed by Indigo Golf Partners
Privacy PolicyTerms of ServiceAccessibility Statement