Employee Screening
WDFHT
Name: *
Do you have any of the following new or worsening symptoms or signs? (Symptoms should not be chronic or related other knows causes or conditions). *
Required
Have you traveled outside of Canada the past 14 days? *
Have you come in close contact with a confirmed or probable case of COVID-19. *
Results of Screening Questions:
If the individual has no symptoms and answers NO to questions 2 and 3, they have passed and can enter the workplace.

If the individual has one or more symptoms and /or answers YES to any question, they 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 (1-800-797-0000) to find out if they need a COVID-19 TEST.
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