COVID-19 Illness Contingency Plan - Florida Institute of Oceanography

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Date

Group Leader/PI Name and Affiliation

Group Leader/PI Email Address

I have read and understand the 'FIO Operations COVID Reopening Actions & Expectations' and have reviewed the 'Medical Facilities in Monroe County' documents on the FIO/KML Website

Acknowledge

All persons in this group are covered by either their home institution's insurance or have personal insurance for necessary medical treatment

Acknowledge

Plans for isolation and quarantine of individual(s) of concern until departure:

Plans for diagnostic testing (if necessary):

Plans for accessing medical care if needed (local urgent care, hospital, health department, etc.)

Plans for safe return to home facility or local off-site housing:

We understand the inherent risks are assumed by our institution, group leader/PI, and all individuals, as KML staff cannot offer support in the event of KML closure to isolate and quarantine

Acknowledge

E-Signature

To be completed by KML Staff:

Reviewed and approved by:

Date