Daily Screening Form (V. 2)

The above document is the second version of Merrimack’s COVID-19 daily screening form and liability waiver, issued in August of 2020. It is a double-sided sheet that has two different types of criteria. One of the sides has a COVID-19 screening checklist, asking the signee to report any symptoms, travel, or possible exposure to the virus. The other side of the sheet is a form waiving the college of any liability for the possible contraction of the virus when on campus. According to Task Force member Traci Alberti, “This screening form was developed in May 2020 in preparation of the campus reopening during fall 2020; it was based on the current the CDC and MA DPH [Massachusetts Department of Public Health] guidelines at the time; we worked to make sure we stayed current with the evolving guidelines and to be sure the description and language we used was clear and understandable.”

This COVID-19 screening form was used during the first few weeks of the 2020 fall semester. Soon, the CoVerified app took its place for students, faculty, and staff. The app allowed users to report symptoms and possible COVID-19 contacts, schedule COVID-19 testing, view and manage test results, and move about campus safely. Even after the deployment of CoVerified, though, various version of the above forms were still used by visitors to campus.


Sullivan 304C

Accession Number



Grace Russo

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