Employee Daily COVID Screening

1. Do you have any of the following new or worsening symptoms or signs?

Symptoms should not be chronic or related to other known causes or conditions.

Fever or chillsCoughLoss of sense of smell or tasteDifficulty breathingSore throatLoss of appetiteExtreme fatigue or tirednessHeadacheBody achesNausea or vomitingDiarrhea

Yes, I have symptoms and have indicated above.No, I have none of the above symptoms.

2. Have you travelled outside of Canada in the past 14 days? YesNo

3. Have you had close contact with a confirmed or probable case of COVID-19? YesNo

4. Have you been identified by Public Health as a close contact of someone with COVID-19? YesNo

5. Have you been told to isolate by Public Health? YesNo

If your answer is NO to all questions from 1 through 5, you have passed. Please sign and submit below.

If your answer is YES to any questions from 1 through 3, you have not passed. You should go straight to a testing facility for COVID screening and then home immediately to self-isolate until negative result is received.

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Employee Daily COVID Screening

IN OFFICE REQUIRED SCREENING

Employee Daily
COVID Screening