Run with Rotary 2024
Arbor Day Tree Festival

Employee Return-to-Work Evaluation for COVID-19

This form is to be completed each day that you report to work, within one hour of your “report to work” time. Your response will automatically be sent to the Administration, who will consult with the Health Department on any technical questions.
Are you fully vaccinated (2 doses of Moderna or Pfizer vaccine or 1 dose of J&J vaccine) against COVID-19?
If not vaccinated, have you traveled outside of the state of New Jersey within the past 14 days?
If not vaccinated, over the past 14 days have you been in close contact with any person (someone either in the same household or someone within 6 feet for more than 10 minutes) who has tested positive for COVID-19?
Have you had a temperature of 100.4 or higher within the past three days?
Have you had any of the following symptoms within the past three days?
**If you are reporting shortness of breath, loss of taste or smell and/or coughing unrelated to allergies you must provide a Negative COVID Test in order to return to work. If you report any 2 of the remaining symptoms you must provide a Negative COVID test in order to return to work. **

Community Center

Otto Kaufman
356 Skillman Road
Skillman, NJ 08558
(609) 466-3023

Main Offices

Police

Emergency: Dial 911
Non-Emergency: (908) 359-3222