How to Use the Sample Health Screening Checklist and Required Coronavirus Supplemental Release Waiver

The Sample Health Screening Checklist and Required Coronavirus Supplemental Release waiver are designed to help ministries develop screening procedures that help protect your ministry and its people. You can customize these forms to be used for ministry volunteers, visitors, parents/guardians of children, or for participants of any ministry activity. Enlist the help of a locally licensed attorney when creating a health screening form and coronavirus waiver form.

Create procedures that address the following, then communicate the plan to all involved:

  1. How often are the forms completed? Think about: for volunteers, is it prior to a shift or project? For activities, are the forms completed each time the group meets? For day care children, is it each morning?
  2. Who receives the forms? Ensure that the person completing the form knows when to complete it, who receives it, and how it is delivered.
  3. Communicate to all attendees and visitors prior to the event/activity why the forms are necessary for their health, and the safety and resilience of the ministry. Include which symptoms that are included in the screening.
  4. Include information about your ministry’s confidentiality policy. Private health information is confidential and should be shared with ministry workers only on a need to know basis.
  5. Consider a separate, secure location to store individuals’ private health information. Forms should be accessible by a limited number of people authorized to view that type of information in your organization.

Posted December 2020

The information provided in this article is intended to be helpful, but it does not constitute legal advice and is not a substitute for the advice from a licensed attorney in your area. We strongly encourage you to regularly consult with a local attorney as part of your risk management program.