After sale service

COVID-19 DAILY SCREENING QUESTIONNAIRE

All Workplaces are required to implement this screening questionnaire to ALL WORKERS or essential visitors entering the work environment.

Screening must occur before a worker enters the workplace at the beginning of their day or shift, or when an essential visitor arrives.

Anyone who does not pass screening should not enter the workplace and should: Self-isolate, Call their health care provider or Telehealth Ontario.

Once an individual has passed the screening questions, they will be allowed to enter the workplace, but should report any symptoms immediately if symptoms develop.

Please complete the bellow questionnaire. Scroll to the bottom of the page and click SUBMIT.


REQUIRED SCREENING QUESTIONS

1) Do you have any of the following symptoms? Choose any/all that are new/worsening and not related to other known causes or conditions:

Fever or chills

Difficulty Breathing

Cough (not related to other known causes or conditions or a previous health diagnosis)

Decrease or loss of smell or taste

Sore throat/trouble swallowing (not related to other known causes or conditions for example, seasonal allergies, acid reflux)

Runny nose, or stuffy/congested nose (not related to other known causes or conditions for example seasonal allergies, being outside in the cold weather)

Headache that's unusual or long lasting (not related to other known causes or conditions for example tension-type headaches, chronic migraines)

Nausea, vomiting, diarrhea, abdominal pain (not related to other known causes or conditions for example irritable bowel syndrome, anxiety in children, menstrual cramps)

Extreme tiredness, sore muscles not feeling well (not related to other known causes or conditions for example depression, insomnia, thyroid dysfunction, sudden injury)

2) Have you travelled outside of Canada in the past 14 days?

3) Have you had close contact with a confirmed or probable case of COVID-19?

Contact Information:

Please Indicate the Site you work at:





Do you work at Head Office, Sales or Service?

If you answer NONE OF THE ABOVE to question 1 and NO to questions 2 and 3 you can enter the workplace.

If you answered YES to any questions from 1 to 3, you cannot enter the workplace and must contact your health care provider or Telehealth ON (1-866-797-000) to determine if a COVD-19 test is required. Visit https://covid-19.ontario.ca/self-assessment (Min. of Health, ON). Follow the instructions and save the results when instructed to do so.