Banff Caribou Properties Health Screening
Sign in to Google to save your progress. Learn more
First Name *
Employee Number *
Work Location *
COVID-19 SYMPTOMS
-fever
-new onset of cough or worsening chronic cough
-new or worsening shortness of breath or difficulty breathing
-sore throat
-runny nose
-loss of sense of smell or taste
Do you have any of the symptoms listed above? *
Required
If you answered "YES" to the previous questions, you are required to self-isolate and get tested for COVID-19. You must stay in isolation until your test results are received. IF THE RESULTS OF YOUR TEST ARE NEGATIVE, YOU MAY RETURN TO WORK ONCE YOUR SYMPTOMS HAVE RESOLVED.
Complete the Alberta COVID-19 Self- Assessment for information on how to book at COVID-19 test.
Screening Completed. Click Submit.
Thank you for completing the screening.
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy