COVID-19 Health Screening Web
With Event Horizon Theme

"Health Screening Web Form"

Integrate This Mobile Friendly Form Now!
COVID-19 Health Screening Web Form Template

When it comes to ensuring the health and safety of your community, look no further than the COVID-19 Health Screening Web Form. This essential tool allows you to collect crucial health information efficiently, helping to prevent the spread of COVID-19 by screening for symptoms, recent contacts, and travel history. Seamlessly integrated into your website, this secure form demonstrates your commitment to public health and safety, making it a must-have for healthcare facilities, educational institutions, corporate offices, and event organizers.

Pairing the COVID-19 Health Screening Web Form with the striking Event Horizon Theme elevates your form to a whole new level. With its bold dark background, seamless design, and cosmic red accents, this theme commands attention and exudes sophistication. The borderless inputs and standout red submit button create an engaging environment for users, ensuring easy readability and efficient data entry. Ready to showcase your dedication to health compliance and safety? Get started with the COVID-19 Health Screening Web Form and Event Horizon Theme today!

COVID-19 Health Screening Web Features

Streamline Health Assessments
Streamline Health Assessments
Efficiently collect vital health information with our COVID-19 Screening Form, ensuring safety compliance.
Enhance User Experience
Enhance User Experience
Seamless integration and user-friendly design make health screening accessible to all.
Safeguard Public Health
Safeguard Public Health
Demonstrate commitment to safety by implementing thorough health checks with our form.
Bold & Engaging Design
Bold & Engaging Design
Captivate users with the striking "Event Horizon" theme, blending aesthetics with functionality.
Dark Mode Elegance
Dark Mode Elegance
Embrace sophistication and power with a borderless design and striking red accents.
Real-Time Updates
Real-Time Updates
Stay informed with interactive features that adapt to evolving health guidelines and situations.
COVID-19 Health Screening Web Form Template
Customizable Form Fields
You can add, remove or re-arrange form fields when using our form builder app.
title (html-block)
fullName* (text, input)
Full Name
email* (email)
Email Address
phoneNumber* (phone-number)
Phone Number
symptoms* (boolean, buttons)
Have you experienced any COVID-19 symptoms in the last 14 days?
contact* (boolean, buttons)
Have you been in close contact with a confirmed or probable COVID-19 case?
travel* (boolean, buttons)
Have you traveled internationally in the last 14 days?
additionalInfo (text, textarea)
Additional Information

Try Out the Form for Yourself!

Experience Ease and Flexibility Across Multiple Devices and Screens

The form below is using our "Event Horizon" form theme. You can change the colors and the theme using the Wizara Form Builder app.