GHS Covid-19 Self-assessment

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

GHS Covid-19 Self-assessment - F22

All GHS Staff are required to complete and submit this self-assessment prior to entering the workplace.

Anyone who is sick or has any symptoms of illness, including those not listed in this screening tool, should stay home and seek assessment from their health care provider if needed.

If you DO NOT PASS screening, you should not enter the workplace and should self-isolate, following the instructions on the Ontario COVID-19 Self-Assessment (https://covid-19.ontario.ca/self-assessment/)

If you DO PASS the screening, you may proceed with entering the workplace. Any chronic symptoms you have should be reported immediately to your Team Lead.

First and Last Name *

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms