Building Access
COVID-19 "Building Access" Declaration

We require you to fill out the below questionnaire to assist in determining your fitness for building access during the COVID19 pandemic to provide a safe environment for the public. The information will be used and disclosed solely for the purposes of determining  access during the COVID-19 pandemic.

Question Title

* 1. Your Name:

Question Title

* 2. Your e-mail address:

Question Title

* 3. Building (select all that apply):

Question Title

* 4. Are you or anyone in your household (including guests) showing any of the following SYMPTOMS:
a. Fever (38 degrees Celsius or higher),
b. Cough,
c. Shortness of breath,
d. Difficulty breathing,
e. Sore throat, or
f. Runny nose.

Question Title

* 5. Have you or anyone in your household (including guests) had INTERNATIONAL travel in the last 14-days?

Question Title

* 6. Have you or anyone in your household (including guests) had DOMESTIC air travel in the last 14-days?

Question Title

* 7. Have you or anyone in your household (including guests) had contact with anyone who has tested positive for COVID-19 or who are currently waiting for test results on COVID-19?

Question Title

* 8. I have answered all the questions to the best of my knowledge?

T