COVID Screening: Administration Office
This screening, combined with program attendance records where applicable, may be used to support contact tracing in consultation with Public Health.

STAFF: All employees are required to complete this screening questionnaire each day prior to reporting for work. A temperature check is required upon arrival at your work location. If you have any symptoms or feel ill, please do not report to work. Instead notify your supervisor immediately. After a failed screening, follow the guidance regarding return to work.

VISITORS: All visitors, including parents and children, who have been approved to enter the building at 10 Washburn Drive are required to complete a COVID-19 screening.

GENERAL INFORMATION FOR ALL:
This tool provides basic information only and contains recommendations for staff and visitors to support decision making about whether the individual should enter the building and/or needs to be tested for COVID-19. It is not to be used as a clinical assessment tool or intended to take the place of medical advice, diagnosis or treatment.

When assessing for the symptoms below, you should focus on evaluating if they are new, worsening, or different from your baseline health status or usual state. If yes, select that symptom. Symptoms associated with known chronic health conditions or related to other known causes/conditions should not be considered unless new, different or worsening (If no, leave blank and select None of the Above).

Email address *
Today’s date *
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I am completing this screening as a: *
Your First & Last Name *
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