Attestation of No COVID-19 Symptoms and Agreement to Follow the Buck Physical Distancing Protocol and Mask Guidelines

This agreement must be completed each day, prior to entering the building.

Buck Physical Distancing Protocol—Updated July 21, 2020

Buck Institute has taken extensive precautions to limit the spread of COVID-19 on our campus. To ensure compliance with the latest local public health orders, we are providing you with this summary of actions we have taken.

    Visit the COVID-19 Information and Resources page on the Buck Intranet for more details. You may contact Juniper Pennypacker at or Danielle Herrerias at , with any questions or comments about this protocol.

    Buck Institute is taking the following measures to ensure the health of our employees and their families:

  • Buck Institute requires everyone entering the building to remain six feet apart, whenever possible, and abstain from physical contact, including shaking hands. Individuals in common areas including restrooms, alcove and break rooms, and the like, are asked to maintain six feet of physical distance. Use the stairs when possible. No more than two persons shall ride in an elevator at the same time.
  • Buck requires everyone entering the building to observe good hygiene and cough or sneeze into their elbows or a tissue.
  • All Buck employees who can carry out their work duties from home are encouraged to speak to their supervisor about working remotely.
  • Employees are not to come to work if they are sick.
  • Anyone with cough, fever, or other symptoms of the COVID-19 virus should not enter the building.
  • Self-attestation symptom checks and screenings are required before employees, students, visitors, tenants and vendors may enter the building.
  • Where possible, desks or individual work stations should be separated by at least 6 feet.
  • Disinfecting break rooms, restrooms, common areas, and high contact surfaces has increased.
  • There are an increased number of hand sanitizer stations available, including inside and outside each campus entry point.
  • Soap and water are available to all employees and the public at all restrooms and select other hand washing stations.
  • Buck has a Universal Mask Policy that applies to everyone on campus and in the building.
  • All non-essential events and gatherings are canceled or postponed.
  • Buck has been officially designated an essential “healthcare operation” which enables the Institute to continue scientific research while adhering to social distancing requirements.
  • Areas that are used for gathering, such as the auditorium, conference rooms, and the cafeteria, are closed.
  • Buck requires that meetings take place remotely.

    Copies of this protocol have been distributed to all employees.


  • * Denotes a required field

  • In order to be at the Buck campus, you must verify you DO NOT have any of the following symptoms and the below statements are true:
    1. I do not currently have any of the following symptoms of COVID-19 infection:
      • Fever (≥37.8°C/100°F)
      • New onset cough
      • Shortness of breath or difficulty breathing
      • Headache
      • Nausea
      • Sore throat
      • Nasal congestion or runny nose (different from pre-existing allergies)
      • Loss of sense of smell or taste
      • Diarrhea
      • Conjunctivitis (pink eye)
      • Unexplained body aches
    2. I have not been diagnosed with COVID-19 within the previous 14 days.
    3. I have not been in contact with someone who has been diagnosed with COVID-19 within the previous 14 days.
    4. In the past 14 days, I have not been identified as a contact requiring self-monitoring for symptoms by Buck or by a public health agency as part of “contact tracing” related to someone diagnosed with COVID-19.
    5. I have been in the state of California for at least the past 14 days.
    6. I am entering the facility to conduct scientific research or to provide essential onsite support services including environmental and sanitation services, facilities, engineering, information technologies and administrative services such as shipping, purchasing, and finance.
    7. I am adhering to the Buck Physical Distancing Protocol and Universal Mask Guidelines, as posted in the building and on the Buck Intranet.
    8. I have not taken any medication to mask symptoms of fever and infection such as acetaminophen, ibuprofen, aspirin, or certain cough medications.
    If you check YES, above, please do not enter the facility, quarantine at home, contact your primary care provider and reach out to
  • Please sign above by typing your name

    Be sure to check YES or NO to symptoms above before submitting!