Covid Screening Questionnaire

Please fill out the following form before or on your arrival to work each day.

Do you have any of the following new or worsening symptions? Symptons that aren't cronic or related to other known contions. FEVER, SHORTNESS OF BREATH, COUGH, SORE THROAT, LOSS OF SMELL/TASTE, NAUSEA OR DIARRHEA, EXTREME FATIQUE, SORE MUSCLES.
Have you travelled outside of Canada in the last 14 days?
Have you come in contact with a confirmed or probable case of COVID 19?

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