BMB A/Z E211 Access Request Form – College of Natural Sciences Forms

Name*

First Last

CSU Email Address*

CSUID #*

Use Policy

To minimize your risk of contracting and spreading COVID-19 we ask that you read through and agree to the use policies below while using A/Z E211. Anyone reported as not adhering to the Use Policy below may have their user privileges removed.

Wear a mask that covers your face and nose at all times.*

I agree

Disinfect the computer desk surface, keyboard and mouse PRIOR to use with the wipes provided within the room.*

I agree

Disinfect the printer interface and paper tray PRIOR to use (if applicable).*

I agree

Sit only at designated stations.*

I agree

Maintain 6' social distancing at all time.*

I agree

Close the door when entering and exiting the room.*

I agree

Only use if not currently experiencing any COVID-19 symptoms*

Symptoms Include:

Fever >100.4
Cough
Shortness of breath
Runny nose
Headache
Body aches
Sore throat
Nausea/vomiting
Diarrhea Loss of taste or smell
Chills

I agree

Consent*

I agree to the use policy.