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COVID-19 Health Screening Web
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With Prairie Capital Theme
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"Health Screening Web Form"

Revolutionize Your Website or App by Adding This Form!
COVID-19 Health Screening Web Form Template

COVID-19 Health Screening Web is an essential tool for organizations prioritizing health and safety. This comprehensive form collects crucial health information efficiently, ensuring individuals at risk are identified before entering premises. Integrated seamlessly into websites, it showcases a commitment to public health compliance and safety, making it a must-have for healthcare facilities, educational institutions, corporate offices, and event organizers.

Pairing the COVID-19 Health Screening Web with the Prairie Capital theme enhances user experience with its inviting design and mobile-friendly layout. The theme's very round corners and loud submit button create a visually appealing and engaging form that stands out. Elevate your health assessment process with this powerful combination today and take proactive steps towards a healthier environment for all.

Ready to prioritize health and safety with a user-friendly form? Build your COVID-19 Health Screening Web form with the Prairie Capital theme now!

Get Started Using This Form Template

COVID-19 Health Screening Web Features

Streamlined Health Assessment
Streamlined Health Assessment
Efficiently collect vital health information for COVID-19 screening with a user-friendly web form.
Compliance Assurance Tool
Compliance Assurance Tool
Demonstrate due diligence in safeguarding health by integrating this secure form into your website.
Versatile Healthcare Solution
Versatile Healthcare Solution
Ideal for healthcare facilities, educational institutions, corporate offices, and event organizers.
Inviting Prairie Capital Theme
Inviting Prairie Capital Theme
Engage users with a bright, mobile-friendly design featuring very round corners and a loud submit button.
Standout Submit Button
Standout Submit Button
Guide users to completion with a bold, prominent submit button that commands attention.
Accessible User-Centric Design
Accessible User-Centric Design
Optimized for mobile users, this theme offers a clean layout for easy navigation and engagement.
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)
title
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 "Prairie Capital" form theme. You can change the colors and the theme using the Wizara Form Builder app.