Employee Questionnaire

The safety of our employees and patrons is our top priority. As the coronavirus disease 2019 (COVID-19) outbreak continues to evolve we monitor the situation closely and will periodically update guidance based on current recommendations from the Centers for Disease Control and Prevention. To prevent the spread of COVID-19 and reduce the potential risk of exposure to our workforce and visitors, we are conducting a simple screening questionnaire. Your participation is required to help us take precautionary measures to protect you and everyone in this building.

Reporting to NLS?  Use this form instead.


  • Self-Declaration by Employee

  • IF THE ANSWER IS “YES” TO ANY OF THE QUESTIONS, YOU SHOULD NOT ENTER THE BUILDING! PLEASE CONTACT THE LIBRARY DIRECTOR FOR FURTHER GUIDANCE. IF YOU HAVE TESTED POSITIVE FOR COVID-19 YOU WILL NEED TO OBTAIN CLEARANCE FROM A MEDICAL PROFESSIONAL CERTIFYING YOUR FITNESS TO RETURN TO WORK.

    Note: Please immediately advise the Director, Assistant Director or Administrative Assistant if any of your responses change at any time.

  • This field is for validation purposes and should be left unchanged.