COVID-19 Health Assessment

Before entering any Bressler, Amery & Ross office location, all Bressler visitors, whether fully vaccinated or not, must submit the Bressler COVID-19 Health Assessment. The disclosure is required to safeguard health, safety, and limit transmission in the Bressler community. If you aren’t feeling well, even if you are fully vaccinated, stay home, contact your physician, and take care of yourself.

Name*

Email*

Phone*

Which Bressler location are you visiting?* Austin Birmingham Charlotte Dallas Florham Park Fort Lauderdale Houston New York Oklahoma City

Who are you visiting at Bressler?*

Purpose of the visit if not a Bressler employee

Check here if you are a Bressler Employee

Are You Fully Vaccinated?*

Yes

No

Are you experiencing any cold or flu-like symptoms (including fever, cough, sore throat, respiratory illness, or difficulty breathing)?*

Yes

No

If you are not fully vaccinated you are required to wear a mask while visiting any Bressler office. If you responded ‘Yes’ to the second question we ask that you take a COVID test prior to visiting Bressler and if that test is negative, please wear a mask while visiting. If you have any questions contact Bressler’s HR Department at selfevaluation@bressler.com.

Enter code shown below*

X Code

* Indicates a required field.