Home » COVID-19 Daily Screening September 2021
All employees and visitors entering the premises MUST complete this form PRIOR TO or IMMEDIATELY upon entering building.
For individuals who are 18 years of age and older:
Please read the following statement and answer YES or NO below:
1. Are you currently experiencing one or more of the symptoms below that are new or worsening? Symptoms should not be chronic or related to other known causes or conditions.
Fever and/or chills: Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher;
Cough or barking cough: Not related to asthma, post-infectious reactive (croup) airways, COPD, or other known causes or conditions you already have;
Shortness of breath: Not related to asthma or other known causes or conditions you already have;
Decrease or loss of smell or taste: Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already have;
(For adults 18 years or older) Fatigue, lethargy, malaise and/or myalgias (muscle aches and pains): Unusual tiredness, lack of energy (not related to depression, insomnia, thyroid dysfunction, or other known causes or conditions you already have.) If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild fatigue that only began after vaccination, select "No".;
(For children less than 18 years) Nausea, vomiting and/or diarrhea: Not related to irritable bowel syndrome, anxiety, menstrual cramps, or other known causes or conditions you already have.
Results of Screening Questions:
If you answered "NO" to all questions 1 through 7 - you can enter the workplace.
If you answered "YES" to any questions from 1 through 7, you cannot enter the workplace (including any outdoor or partially outdoor workplace).
You must inform your employer (manager/supervisor) of this result and go home or stay home to self-isolate immediately and contact your health care provider or Telehealth Ontario (1-866-797-0000) to get advice or an assessment including if you need a COVID-19 test. Contact and inform your supervisor or manager at the earliest opportunity for further direction.
If you answered "YES" to question 7, you must stay home, along with the rest of the household, until the sick individual gets a negative COVID-19 test result, is cleared by their local public health unit, or is diagnosed with another illness.
If any of the answers to these screening questions change during the day, you must inform your supervisor or manager of the change and go home to self-isolate immediately. Contact your health care provider or Telehealth Ontario as above.
VISITORS
If you answered "YES" to any questions from 1 through 7 you CANNOT enter this workplace. You should go home to self-isolate immediately and call your health care provider or call Telehealth Ontario (1-866-797-0000) to find out if you need a COVID-19 test.