We require you to fill out the below questionnaire to assist in determining your fitness for duty during the COVID19 pandemic to provide a safe environment for staff, homeowners and homebuyers, other trades and suppliers and the public. The information will be used and disclosed solely for the purposes of determining fitness for work during the COVID-19 pandemic.

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* Your Name:

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* Your Company Name:

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* Community (select all that apply):

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* Are you showing any of the following SYMPTOMS (that is NOT related to a pre-existing illness or health condition) :
a. Fever (38 degrees Celsius or higher),
b. Cough,
c. Shortness of breath,
d. Sore throat, or
e. Runny nose?

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* Have you had INTERNATIONAL travel in the last 14-days?

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* In the last 14 days, have you had close contact with anyone who has tested positive for COVID-19 AND you are NOT fully immunized?

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