Chippewa Hotel
Mackinac Island's Best
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Pink Pony
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Rooms / Rates
Specials / Packages
Pink Pony
Shop
Merchandise
Gift Cards
COVID-19
Employee Health Test
Employee Health Test
First Name
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Last Name
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Date
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Did you vomit in the last 24 hours?
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Yes
No
Have you had diarrhea in the last 24 hours?
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Yes
No
Have you experienced shortness of breath in the last 24 hours?
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Yes
No
Have you had a persistent cough in the last 24 hours?
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Yes
No
Have you come in contact with a person positive for COVID-19 in the last 24 hours?
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Yes
No
Unknown
Have you had a fever or felt feverish in last 24 hours?
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Yes
No
Please record your temperature here if available
Please record any COVID-19 related symptoms you have experienced in the last 24 hours
If you are human, leave this field blank.
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