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Flu-Like Illness Reporting Form

Please use this site to report flu-like illness. Fill out this form if you or a member of your family exhibits symptoms such as fever, sore throat, cough, stuffy nose, chills, headache, body aches, nausea, vomiting or diarrhea.

This form will need to verify your identity by checking for your computer's KCA certificate. If you do not have a KCA certificate or cannot access this form, please click here to download the form as a Word document. Copy the file to your computer, fill it out and e-mail it to medical_office@fnal.gov. You can also copy the text of the form into an e-mail, enter your responses and send it to the Medical Office.

Filling out this questionnaire does not obviate the need to inform your supervisor that you will be out of the office. Please let him or her know as well.

If you feel sick, please stay home from work. Fermilab has instituted a more permissive stance on sick leave usage http://wdrs.fnal.gov/policies/policy/sickleaveH1N1.html in light of the extraordinary circumstances.

Please call the Medical Office before you return from work after time off for flu-like illness.