Page 423 - Safety Memo

 Management will provide for coordination of travel arrangements, food and accommodations for
individuals supporting the recovery effort.
 Non-critical Company functions and associated personnel will be made available to support the
recovery efforts.

Returning Employees

Employees returning to the company must be managed in small groups. Employees should be
interviewed to determine their existing condition and fitness to return to work. The following
questions, at a minimum, should be asked.

 Has the employee been in contact with anyone diagnosed with the pandemic virus or disease?
 Has the employee been in contact with anyone who demonstrated flu like symptoms but were
never checked at a medical facility?
 Has the employee attended any events in the past 2 weeks where anyone was diagnosed with the
pandemic virus or disease?

 Is the employee experiencing now or have they experienced flu like symptoms in the past 2
weeks?

Return to Work Form

Employee Name:

Date: Time:

Interviewed By:
QUESTIONS YES NO
Have you been in contact with anyone diagnosed with the pandemic virus or
disease?
Have you been in contact with anyone who demonstrated flu like symptoms but
were never checked at a medical facility?
Have you attended any events in the past 2 weeks where anyone was diagnosed
with the pandemic virus or disease?
Are you experiencing now or have you experienced flu like symptoms in the past
2 weeks?

Employee Signature:

Interviewed by Signature:

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