COVID-19 PRE-SCREENING QUESTIONNAIRE - Employees
โ€œMylen is actively taking steps to mitigate the spread of Coronavirus (โ€œCOVID-19โ€) and is taking all reasonable and necessary health and safety precautions, including measure to ensure social distancing and high levels of hygiene in the workplace. All employees of Mylen are required to follow the safety protocols, as set forth by the Company, and in accordance with Government and Public Health authorities, to sustain a healthy and safe workplace during this pandemic. In order to ensure the best interests of our staff, when working in our facilities or providing in-person services in the showroom, on a clientโ€™s residence and/or job site, ๐—”๐—Ÿ๐—Ÿ ๐—ฒ๐—บ๐—ฝ๐—น๐—ผ๐˜†๐—ฒ๐—ฒ๐˜€ ๐—ฎ๐—ฟ๐—ฒ ๐—ฟ๐—ฒ๐—พ๐˜‚๐—ถ๐—ฟ๐—ฒ๐—ฑ ๐˜๐—ผ ๐—ฐ๐—ผ๐—บ๐—ฝ๐—น๐—ฒ๐˜๐—ฒ ๐˜๐—ต๐—ถ๐˜€ ๐—ฝ๐—ฟ๐—ฒ-๐˜€๐—ฐ๐—ฟ๐—ฒ๐—ฒ๐—ป๐—ถ๐—ป๐—ด ๐—พ๐˜‚๐—ฒ๐˜€๐˜๐—ถ๐—ผ๐—ป๐—ป๐—ฎ๐—ถ๐—ฟ๐—ฒ ๐—ฃ๐—ฅ๐—œ๐—ข๐—ฅ ๐˜๐—ผ ๐—ฒ๐—ป๐˜๐—ฟ๐˜† ๐—ถ๐—ป๐˜๐—ผ ๐˜๐—ต๐—ฒ ๐˜„๐—ผ๐—ฟ๐—ธ๐—ฝ๐—น๐—ฎ๐—ฐ๐—ฒ, ๐—˜๐—”๐—–๐—› ๐——๐—”๐—ฌ ๐˜๐—ต๐—ฒ ๐—ฒ๐—บ๐—ฝ๐—น๐—ผ๐˜†๐—ฒ๐—ฒ ๐˜€๐—ฒ๐—ฒ๐—ธ๐˜€ ๐˜๐—ผ ๐—ฒ๐—ป๐˜๐—ฒ๐—ฟ ๐˜๐—ต๐—ฒ ๐˜„๐—ผ๐—ฟ๐—ธ๐—ฝ๐—น๐—ฎ๐—ฐ๐—ฒ.

Please answer the following questions honestly and as accurately as possible:
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Email *
Name of Employee *
Have you travelled outside of Canada within the last 14 days? *
Have you been in contact with anyone who has travelled outside of Canada within the last 14 days, and that is showing symptoms of COVID-19? *
Have you come into close contact (within 6 feet) with someone who has a confirmed COVID-19 diagnosis within the last 14 days? *
Do you have a new onset of any of the following symptoms: Fever/Chills, Runny nose/Sneezing, Sore throat/hoarse voice, Headache, Vomiting or diarrhea for more than 24 hours, Cough, Shortness of breath, Fatigue, Muscle aches?โ€ *
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