QUESTION 1:

Have you traveled to China, Iran, Europe, Japan, or South Korea

within the last 14 days?

QUESTION 2:

Have you been in close contact with any person who has a confirmed

case of COVID-19?

Allow the individualto enter the base.

NOYES YES

If Contract EmployeeIf Active Duty or DoD Employee

Take these actions:

· Don N95 respirator, andprovide a surgical mask.

· Deny entry until cleared bymedical personnel.

· Call EMDG: 442-2273

Take these actions:

· Don N95 respirator, andprovide a surgical mask.

· Collect identifying information.

· Deny entry until cleared bymedical personnel.

· Advise the individual tocontact their company.

· Call Medical Liaison Officer:97999799

Coronavirus (COVID-19) Screening Questionnaire

Base Entry - Ali Al Salem

INSTRUCTIONS: Ask each person the two questions below. If an individual answers yes to EITHER question, execute the actions in red as appropriate for the status of the person. If an individual answers no to BOTH questions, allow them to enter.

Identifying Information:

· Full Name · Company Name · Supervisor’s Phone Number· Phone Number · Supervisor’s Name · Supervisor’s Email· Email

Current as of: 13 Mar 2020

QUESTION 1:

Have you traveled to China, Iran, Europe, Japan, or South Korea

within the last 14 days?

QUESTION 2:

Have you been in close contact with any person who has a confirmed

case of COVID-19?

Allow the individual to enter the base/travel.

NOYES YES

If Contract EmployeeIf Active Duty or DoD Employee

Take these actions:

· Don N95 respirator, andprovide a surgical mask.

· Deny entry/travel untilcleared by medicalpersonnel.

· Call EMDG: 442-2273

Take these actions:

· Don N95 respirator, andprovide a surgical mask.

· Collect identifying information.

· Deny entry/travel until clearedby medical personnel.

· Advise the individual tocontact their company.

· Call Medical Liaison Officer:97999799

Coronavirus (COVID-19) Screening Questionnaire

PAX Terminal - Ali Al Salem

INSTRUCTIONS: Ask each person the two questions below. If an individual answers yes to EITHER question, execute the actions in red as appropriate for the status of the person. If an individual answers no to BOTH questions, allow them to enter.

Identifying Information:

· Full Name · Company Name · Supervisor’s Phone Number· Phone Number · Supervisor’s Name · Supervisor’s Email· Email

Current as of: 13 Mar 2020

QUESTION 1:

Have you traveled to China, Iran, Europe, Japan, or South Korea

within the last 14 days?

QUESTION 2:

Have you been in close contact with any person who has a confirmed

case of COVID-19?

Allow the individualto enter the base.

NOYES YES

If Contract EmployeeIf Active Duty or DoD Employee

Take these actions:

· Don N95 respirator, andprovide a surgical mask.

· Deny entry until cleared bymedical personnel.

· Call EMDG: 454-6835

Take these actions:

· Don N95 respirator, andprovide a surgical mask.

· Collect identifying information.

· Deny entry until cleared bymedical personnel.

· Advise the individual tocontact their company.

· Call Medical Liaison Officer:97999799

Coronavirus (COVID-19) Screening Questionnaire

Base Entry - Al Jaber

INSTRUCTIONS: Ask each person the two questions below. If an individual answers yes to EITHER question, execute the actions in red as appropriate for the status of the person. If an individual answers no to BOTH questions, allow them to enter.

Identifying Information:

· Full Name · Company Name · Supervisor’s Phone Number· Phone Number · Supervisor’s Name · Supervisor’s Email· Email

Current as of: 13 Mar 2020

QUESTION 1:

Have you traveled to China, Iran, Europe, Japan, or South Korea

within the last 14 days?

QUESTION 2:

Have you been in close contact with any person who has a confirmed

case of COVID-19?

Allow the individual to enter the base/travel.

NOYES YES

If Contract EmployeeIf Active Duty or DoD Employee

Take these actions:

· Don N95 respirator, andprovide a surgical mask.

· Deny entry/travel untilcleared by medicalpersonnel.

· Call EMDG: 454-6835

Take these actions:

· Don N95 respirator, andprovide a surgical mask.

· Collect identifying information.

· Deny entry/travel until clearedby medical personnel.

· Advise the individual tocontact their company.

· Call Medical Liaison Officer:97999799

Coronavirus (COVID-19) Screening Questionnaire

PAX Terminal - Al Jaber

INSTRUCTIONS: Ask each person the two questions below. If an individual answers yes to EITHER question, execute the actions in red as appropriate for the status of the person. If an individual answers no to BOTH questions, allow them to enter.

Identifying Information:

· Full Name · Company Name · Supervisor’s Phone Number· Phone Number · Supervisor’s Name · Supervisor’s Email· Email

Current as of: 13 Mar 2020