Daily Risk Assessment: Screening Questions

This assessment MUST be completed DAILY prior to entering any Super T Aviation facility. Please read Super T Aviation's COVID-19 Policy and Procedures document available online at www.tinyurl.com/supert-dropbox.

If you have any COVID symptoms or have come in contact with someone who has you are not permitted to enter or visit Super T Aviation facilities at this time. You should self-isolate and call 811. Please inform Super T Aviation if you do develop symptoms or come in contact with someone who has COVID-19.

If you answer “NO” to all of the above, you can proceed to work or with your visit. If you develop symptoms, please complete a new questionnaire and notify Super T Aviation at 1 (403) 548-6636 or contact-us@supertaviation.ca.

Email address *

Do you have any of the following symptoms which are new or worsened if associated with allergies, chronic or pre-existing conditions: fever, cough, shortness of breath, difficulty breathing, sore throat, and/or runny nose? *

Yes

Fever

Cough

Shortness of breath

Difficulty breathing

Sore throat

Runny nose

Have you returned to Canada from outside the country (including USA) in the past 14 days? *

Yes

Considering the IMSAFE acronym, are you fit to fly? *

Yes

In the past 14 days, did you have close contact with someone who has a probable or confirmed case of COVID-19? *

Yes

In the past 14 days, did you have close contact with a person who had acute respiratory illness that started within 14 days of their close contact to someone with a probable or confirmed case of COVID-19? *

Yes

In the past 14 days, did you have close contact* with a person who had acute respiratory illness who returned from travel outside of Canada in the 14 days before they became sick? *

Yes

In the past 14 days, did you have a laboratory exposure to biological material (i.e. primary clinical specimens, virus culture isolates) known to contain COVID-19? *

Yes

Full Name: *

Date Signed: *

YYYY

Have you read Super T Aviation's COVID-19 Policy and agree to the following conditions? *

Yes, I have read Super T Aviation's COVID-19 Policy. All my answers above are true and correct. I will notify Super T Aviation if I develop symptoms or come into contact with someone who has COVID-19. I understand that I am not permitted into any Super T Aviation facility if I have symptoms or have been in contact with someone who does. I provide consent for Super T Aviation to collect my personal information and understand that they will utilize it in a protected manner in accordance with their Protection of Privacy Policy.

Required

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