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COVID-19 Employee Self Assessment Form

Go 100% digital today

To prevent the spread of the coronavirus and flatten the curve, it’s essential that all field service workers—prior to entering a job site—complete a COVID-19 Employee Self-Assessment Form. These types of forms run through a list of self-assessment questions and automatically notifies managers if the employee’s results could indicate early on-set symptoms so they may take swift action.  

COVID-19 Employee Self-Assessment Forms are ideal for any organization, especially for frontline workers:

  • entering healthcare facilities such as hospitals, long-term care facilities, retirement homes
  • performing medical equipment installation and maintenance services
  • installing or maintaining industrial equipment
  • providing essential services including grocery, utility, infrastructure, construction, community, or transportation services

With ProntoForms, this form can be customized to follow any country-, state- or province-, or organization-specific health protocols. Guide frontline workers through new procedures and collect critical data on their mobile device, including:

  • self-assessments
  • contextual guidance based on the employee’s responses
  • reporting requirements and workflows for symptomatic employees

Rapidly build and deploy custom COVID-19 and emergency response apps. Request a demo to learn how ProntoForms can help. 


Drop that clipboard. Collect data on mobile devices.

Go paperless

Digitize CDC forms and deploy them to field teams instantly.

Work smart in the field

Guide users with step-by-step mobile forms that ensure consistency.

Report back in real-time

Send reports to people and back-end or analytics systems.

Packshot explanation

"We're expecting a very high demand for our field service team. We've been working to ensure that our ProntoForms apps have consistent terminology and that we're all using it the same way. This will help us with onboarding and training additional staff that will surely be needed with our elevated demand." 

Lenny Cumberledge
Field Service Director, Purell

Features designed for rapid emergency response

Rapid onboarding platform

Our user-friendly design and intuitive workflows that most technicians can grab the app and go with little to no training.

Work smart with conditional logic

Ensure fast inspections, investigations, and asset service with dynamic forms that tailor pre-set questions and prompts based on user input.

Work anywhere

Complete and submit mobile forms without on-site connectivity. Forms are auto-sent once network is restored.

Get the full picture with rich media

Emergencies aren't the time to second guess. Collect photos, videos, audio recordings and more for accurate records.

A compliance workhorse

Have complete auditability of work with EHS and FDA guidelines built into custom FEMA damage assessment apps.

Need quicker emergency response?
Go digital with ProntoForms