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 * GEN II FUND SERVICES, LLC COVID-19 PRE-SCREENING SURVEY
   
   Self-screening can help prevent the spread of COVID-19 and other infectious
   illnesses in the workplace.
   
   This Wellness prescreen must be completed before arriving at a Gen II office
   each day.
   
   Based on your responses to any of the included questions, you might be told
   to stay home, and as appropriate, you should follow any directions provided
   by Human Resources.
   
   This survey is not a substitute for professional medical advice, diagnosis,
   or treatment of disease or other conditions, including COVID-19. Always
   consult a medical professional for serious symptoms or emergencies.
   
   Start Questionnaire

 * HAVE YOU EXPERIENCED ANY OF THE FOLLOWING SYMPTOMS DURING THE PAST FIVE DAYS?
   
    * Fever or chills
    * Cough
    * Shortness of breath or difficulty breathing
    * Fatigue
    * Muscle or body aches
    * Headache
    * New loss of taste or smell
    * Sore throat
    * Congestion or runny nose
    * Nausea or vomiting
    * Diarrhea
   
   Yes, I haveNo, I haven't
   Go BackContinue

 * PLEASE ANSWER THE FOLLOWING QUESTIONS ABOUT YOUR POTENTIAL EXPOSURE RISKS.
   
   WITHIN THE PAST 5 DAYS, HAVE YOU BEEN IN CLOSE PHYSICAL CONTACT (6 FEET OR
   CLOSER FOR AT LEAST 15 MINUTES) WITH A PERSON WHO IS KNOWN TO HAVE
   LABORATORY-CONFIRMED COVID-19 OR WITH ANYONE WHO HAS ANY SYMPTOMS CONSISTENT
   WITH COVID-19?
   YES NO
   
   ARE YOU ISOLATING OR QUARANTINING BECAUSE YOU MAY HAVE BEEN EXPOSED TO A
   PERSON WITH COVID-19 OR ARE WORRIED THAT YOU MAY BE SICK WITH COVID-19?
   YES NO
   
   ARE YOU CURRENTLY WAITING ON THE RESULTS OF A COVID-19 TEST?
   YES NO
   
   Go BackContinue

 * PRE-SCREEN RESPONSE CONFIRMATION
   
   Your electronic signature below is an aknowledgement that you have answered
   all of the questions to the best of your knowledge. Your electronic signature
   is the same as a handwritten signature for the purposes of validity,
   enforceability, and admissiblity.
   
   This response is valid only for the date of Feb 23, 2023. You will need to
   complete a new survey for each day you are scheduled to appear at your
   workplace.
   
   Signature
   
   Go BackSubmit

 * COVID-19 RISK FACTORS PRESENT
   
   Based on your responses to Gen II’s Wellness Survey, it is recommended that
   you stay home and not come into the office today.
   
   If you believe that you have received this message in error, please reach out
   to Human Resources to resolve the problem.

 * SURVEY DECLINED FOR TODAY
   
   You have chosen not to complete today's survey and will not be permitted to
   utilize the office for the rest of the day.
   
   If you declined this survey by mistake, please reach out to Human Resources
   or your Maptician administrator to receive a new survey link.