COVID Screening for Condos

**Please note that this screening tool is for Condo Corporation use only. Results will not be monitored. If you develop signs and sysmptoms of COVID with in 14 days of filling up this form, you must inform the Corporation.**

To protect our staff and residents, all contractors and service providers attending or working inside our buildings (including in the units) must be screened for COVID-19 before they enter the building. This screening must be done every day you attend our site.

Please complete the Screening Questionnaire below before entering our building. Once you submit it, a copy of your answers will be sent to the corporation's property manager. You will also get a copy within a couple of minutes of having submitted the form.

Type:

Your name:

Your email address:

Your phone number:

Which building will you are visiting ?

Which area you want to visit?

Purpose of visit?

Date of your visit (Click on calendar to expand):

GENERAL QUESTIONS

In the last 14 days, have you travelled outside of Canada?

Yes

In the last 14 days, have you been identified as a "close contact" of someone who currently has COVID-19?

Yes

In the last 14 days,has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? This can be because of an outbreak, contact tracing, or if you have tested positive.?

Yes

In the last 14 days, have you received a COVID Alert exposure notification on your cell phone? If you already went for a test and got a negative result, select "No."

Yes

HEALTH RELATED QUESTIONS

Are you currently experiencing any of these symptoms? Choose any/all that are new, worsening, and not related to other known causes or conditions you already have.

Fever and/or chills: Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher

Yes

Cough or barking cough (croup): Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have)

Yes

Shortness of breath: Being out of breath, unable to breathe deeply (not related to asthma or other known causes or conditions you already have)

Yes

Sore throat: Not related to seasonal allergies, acid reflux, or other known causes or conditions you already have

Yes

Runny or stuffy/congested nose: Not related to seasonal allergies, being outside in cold weather, or other known causes or conditions you already have

Yes

Decrease or loss of taste or smell: Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already have

Yes

Pink eye: Conjunctivitis (not related to reoccurring styes or other known causes or conditions you already have)

Yes

Headache: Unusual, long-lasting (not related to tension-type headaches, chronic migraines, or other known causes or conditions you already have)

Yes

Digestive issues: Like nausea/vomiting, diarrhea, stomach pain. Not related to irritable bowel syndrome, menstrual cramps, or other known causes or conditions you already have

Yes

Muscle aches: Unusual, long-lasting (not related to a sudden injury, fibromyalgia, or other known causes or conditions you already have)

Yes

Extreme tiredness: Unusual, fatigue, lack of energy (not related to depression, insomnia, thyroid dysfunction, or other known causes or conditions you already have)

Yes

Falling down often: For older people

Yes

DO NOT enter the building if you answered YES to any of the above.

My answers to the above are truthful/ accurate.

I will advise the corporation or the occupants of the unit visited if I develop any of the above symptoms in the next 14 days or if I am diagnosed positive with COVID-19.

By pressing submit you agree to have the above information sent to the condo corporations and/or their management.

The information collected as part of this Screening Process is collected for COVID tracing purpose only. It will be retained by Property Manager for a period of at least one month or more. If requested to do so under the Health Protection and Promotion Act or under any other applicable legislation, our Property Manager may disclosed this information to a medical officer of health or any other authorized agent or inspector. Our Property Manager may also use this information for tracing purposes or to communicate a known case of infection to other users or owners/ occupants or Local Public Health. Should you become positive for COVID-19 in connection with this premises within a 14 day interval please inform us and the Local Public Health. For latest information on COVID-19 prevention measures please contact your Local Public Health.