COVID-19 Health Screening Web
With Industrial Strength Theme

"Health Screening Web Form"

Make Your Site Stand Out with This Quick & Easy Form
COVID-19 Health Screening Web Form Template

When safeguarding health is paramount, the COVID-19 Health Screening Web Form is your go-to solution. Designed for thorough health assessments, this form ensures individuals at risk are identified promptly. Seamlessly integrated into your website, it's user-friendly and secure, collecting vital health information efficiently. Pair it with the Industrial Strength theme for a commanding visual experience. With its black and red palette and large inputs, the theme exudes strength and resilience, making your form stand out with a powerful design.

Elevate your health assessment process with the COVID-19 Health Screening Web Form and the Industrial Strength theme. Showcase your commitment to safety and compliance by utilizing this dynamic duo. Get started today and take a proactive step towards a healthier environment for all.

COVID-19 Health Screening Web Features

Streamline Health Assessments
Streamline Health Assessments
Efficiently collect health data with our COVID-19 Screening Form for seamless pre-screening.
Ensure Compliance and Safety
Ensure Compliance and Safety
Demonstrate due diligence in safeguarding health with our secure and interactive form.
Captivate with Industrial Strength
Captivate with Industrial Strength
Energize users with the commanding "Industrial Strength" theme, showcasing resilience and vigor.
Enhance User Experience
Enhance User Experience
Large inputs and bold colors in the theme deliver a responsive and powerful form design.
Prioritize Strength and Dependability
Prioritize Strength and Dependability
Bridge industrial efficiency with user-focused technology for a robust user experience.
Showcase Commitment to Safety
Showcase Commitment to Safety
Add our COVID-19 Screening Form to your website and take a proactive step towards a healthier environment.
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 "Industrial Strength" form theme. You can change the colors and the theme using the Wizara Form Builder app.