COVID-19 Illness Contingency Plan - Florida Institute of Oceanography

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