As part of that mission, we must ensure the health and well-being of our employees and all visitors to our facilities. To protect against the spread of the COVID-19 (Coronavirus), please answer the following questions BEFORE entering any of our warehouses, offices, or vehicles.

Name

First Name

Last Name

Contact Phone # + Email (if applicable)

Company Name

Reason for visit

To ensure the safety and health of our employees and visitors, ORS is currently refusing access to any persons potentially at high risk of spreding the COVID-19 (Coronavirus). Please answer the follwing questions.

Are you currently or have in the last 14 days experienced any of the following symptoms? FEVER, COUGH, SHORTNESS OF BREATH.

Seek medical advice if you develop symptoms, and have been in close contact with a person known to have COVID-19 or if you live in or have recently been in an area with the ongoing spread of COVID-19.

Yes

No

Please Specify your home country, and any states or countries you've visited in the past 14 days

To the best of your knowledge, have you been in direct contact with any person infected by COVID-19 in the past 14 days?

Yes

No

I attest the information is correct to the best of my knowledge

Follow along with us #WorkWithOrange