COVID-19 Screening Tool for Workplaces

Name:
Shift Start Time:
Shift End Time:

1. Do you have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions.

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?

Resources: