New Registration

Hess is working diligently to take appropriate action to protect the health and safety of our employees, contractors and visitors, and to ensure effective business operations. All visitors are required to complete this questionnaire prior to gaining access to a Hess location. Should you be permitted access, a confirmation and registration number will be emailed to you. You will need the registration number before arriving on location. Registrations are required daily.

If you have a Hess email, please use the following link to complete the form: https://hess.carboncm.com/db/64.

This invitation has expired. Please ask your Hess Host to create another invitation.

The Hess registration application is no longer active. If you have questions, please contact the COVID-19 hotline at 866-348-2246

First Name

Last Name

E-mail

Please provide your actual email address to be able to receive the registration number needed to gain access to any Hess site.

Phone

Company

Work Date

5/13/2024

This Registration is only good for the current date.

Region

Location

Hess Host

Please ensure that you have selected the appropriate host. Selecting the wrong host may delay entry to the site. Continuance of selecting the wrong host may result from denial of access to any Hess site.

Reason for Visit

PENDING REVIEW

1. In the last 10 days have you:

a. Been diagnosed with COVID-19?

b. Directed to self-isolate because of COVID-19 compatible symptoms? Isolation keeps someone who is infected with the virus away from others, even in their home.

c. Directed to quarantine because of exposure to a possible confirmed case of COVID-19? Quarantine is used to keep someone who might have been exposed to COVID-19 away from others.

d. Felt unwell with any symptoms compatible with COVID-19? (fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea).

NOTE - This question may be revised to the latest CDC or equivalent recommendation.

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html

2.If you are fully vaccinated, as defined by the CDC, please answer “no” to this question and move on to question 3. If you are not yet fully vaccinated, in the last 10 days have you:

a. Had close contact (within 6 ft. [2 meters] for 15 minutes or more) with a person confirmed or suspected to have COVID-19? Close contact is defined by the CDC as someone who was within 6 feet of an infected person for a cumulative total of 15 minutes or more over a 24-hour period starting from 2 days before illness onset (or, for asymptomatic patients, 2 days prior to test specimen collection) until the time the patient is isolated.

b. Participated in a social occasion, group event or family gathering with persons outside your immediate household where social distancing was either not possible or not performed (e.g., attending a concert, meeting, church service, wedding, funeral, sports event, indoor dining at a restaurant, going to a bar and other similar activities)?

c. Had a member of your household be designated as a close contact to a confirmed or suspected COVID-19 case?

https://www.cdc.gov/coronavirus/2019-ncov/php/risk-assessment.html

3. In the last 10 days have you:

a. Travelled by public transportation, including but not limited to, air, cruise ship, or train, without face coverings, social distancing, or hand hygiene measures in place?

b. Travelled to or from a COVID-19 area designated as high risk by the local health authority/jurisdiction applicable to you without face coverings, social distancing, or hand hygiene measures in place? If you are unsure if an area is high risk, contact the Hess COVID-19 Hotline (1-866-348-2246).
Note: Fully vaccinated people do not need to get tested before leaving the United States (unless required by the destination) or self-quarantine after arriving back in the United States.

https://www.cdc.gov/media/releases/2020/s038-travel-advisory.html

https://www.cdc.gov/coronavirus/2019-ncov/travelers/after-travel-precautions.html

**Privacy Notice for Online Questionnaire** – US Assets (Employees/Contractors/Visitors)

The purpose of this notice is to inform you about the processing of your personal information by Hess. Consistent with US Center for Disease Control and Prevention (CDC) and World Health Organization (WHO) guidance, Hess is working diligently to protect the health and safety of its employees, contractors, and visitors to its locations and facilities (“Worksites”), and to prevent and/or mitigate the spread of Coronavirus (COVID-19).

**Collection and Use of Your Personal Information**

All persons are required to complete the online questionnaire below to provide information regarding their actual or potential exposure to COVID-19, and whether or not they are experiencing any COVID-19 symptoms, prior to visiting any Hess Worksite. Hess is collecting your information for the purpose of determining whether or not to grant you access to the applicable Hess Worksite, in order to prevent and/or mitigate the spread of COVID-19 among our workforce, visitors and Worksites (the “Purpose”).

**Protection, Sharing, Retention and Disposal of Your Personal Information**

The information you provide, and a record of the decision to grant or deny your access to the applicable Hess Worksite will be kept confidential and shall be made available to those Hess personnel who need to access and process the information in connection with the Purpose, who have been made aware of the confidential nature of the information, and are themselves bound by obligations of confidentiality. Hess may also share your information with: (i) third parties providing services in connection with the Purpose, who are subject to written contractual obligations of confidentiality and data security; and (ii) with other third parties where this is required by applicable law or regulation. Your information will be stored securely, and securely destroyed when no longer needed in connection with the Purpose. Following your completion of the questionnaire and Hess’ review of the information you have provided, you will receive a notification via email sent to your email address, either granting or denying your access to the applicable Hess Worksite. For visitors, the email notification sent to your Hess host confirming whether your access has been approved or denied shall be deleted in accordance with Hess’ email retention procedures.

I agree to inform my site supervisor/host if my condition with respect to the above questions changes prior to my arrival on site.

I have answered these questions truthfully and to the best of my knowledge and understanding.

Employee

Email Domain Starts with

Employee HRG

Email Domain

QT Disallowed Email banner URL: https://hess.carboncm.com/db/64

QT Disallowed Email banner link text: please click here to go to your new landing page

sent to CT at

db88 response status

db88_id

Id: 972596

Invitation Expired

Questionnaire is OFFLINE

Contact Information

Registration Number

Visit Information

Status

Questions

Close Contact Definition

Privacy Notification

Certification

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System

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