Covid Screening Form

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COVID-19 PRE-SCREENING FORM

To ensure the safety of our staff and customers, please fill out the following pre-screening COVID-19 health and safety form upon entering the office or workplace.

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Results of Screening Questions:

If the individual answers NO to all questions from 1 through 3, they have passed and can enter the workplace.

If the individual answers YES to any questions from 1 through 3, they have not passed and should be advised that they should not enter the workplace (including any outdoor, or partially outdoor, workplaces). They should go home to self-isolate immediately and contact their health care provider or Telehealth Ontario (1 866-797-0000) to find out if they need a COVID-19 test.

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