COVID-19 Health Screening Web
With Onyx Pulse Theme

"Health Screening Web Form"

Navigation Perfection: Our Smart Form Simplifies!
COVID-19 Health Screening Web Form Template

When safeguarding health is paramount, the COVID-19 Health Screening Web Form ensures thorough assessments to prevent the spread of COVID-19. Seamlessly integrate this essential tool into your website for efficient data collection on symptoms, contact history, and travel details. Showcase your commitment to safety and compliance by implementing this form for healthcare facilities, educational institutions, corporate offices, and event organizers. Enhance user experience with the Onyx Pulse theme, featuring a dynamic dark-mode design with red and black accents, underlined inputs, and a bold outlined submit button. Make a strong, memorable statement with this engaging theme that commands attention and drives interaction.

Ready to make a bold move towards a healthier environment? Utilize the COVID-19 Health Screening Web Form and Onyx Pulse theme to streamline your health assessment process and showcase your dedication to public health and safety. Customize the form fields to suit your specific needs and leverage the vibrant red and black color scheme of the theme to create a visually impactful experience. Enhance user engagement and make a lasting impression with this powerful combination. Get started building your form with Wizara now!

COVID-19 Health Screening Web Features

Streamlined Health Assessment
Streamlined Health Assessment
Efficiently collect vital health information with a user-friendly COVID-19 Screening Form.
Proactive Health Compliance
Proactive Health Compliance
Demonstrate due diligence in safeguarding health with real-time updates and guidelines.
Secure Data Protection
Secure Data Protection
Ensure HIPAA compliance and protect personal health information with our secure form.
Engaging Dark-Mode Experience
Engaging Dark-Mode Experience
Captivate users with a dynamic Onyx Pulse theme, perfect for bold brands and dark-mode enthusiasts.
Bold Call to Action
Bold Call to Action
Drive interaction with a compelling red outlined submit button that commands attention.
Customizable Design Elements
Customizable Design Elements
Tailor your form with traits like underlined inputs and dark backgrounds for a unique user experience.
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 "Onyx Pulse" form theme. You can change the colors and the theme using the Wizara Form Builder app.