COVID-19 Screening Questionnaire

To assure the safety and well-being of the New Jersey Department of Community Affairs’ employees and its visitors, please answer the following questions before entering a DCA facility. This will help the Department in its effort to provide a safe environment by helping prevent the spread of the coronavirus and reduce the potential risk of exposure.

FORM FOR STAFF

Please ensure you are logged into Office.com with your DCA account (first.last@dca.nj.gov).

You can check that on the office.com home page by clicking on the circle with initials in the upper right of the page and confirming your DCA email is referenced:  

If not click sign out and sign back in with your DCA email account.

Click here for STAFF SCREENING QUESTIONNAIRE

FORM FOR VISITOR'S