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Daily report
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Name
*
Are you experiencing any of the following new on set symptoms? Fever or Chills Cough Sore throat Difficulty breathing Diarrhea Nausea and/or vomiting Extreme fatigue or tiredness Body aches Loss of appetite Headache Loss of sense of smell or taste
*
YES
NO
Have you traveled outside of Canada, including the United States, within the last 14days?
*
YES
NO
Have you been identified as a close contact of a COVID-positive case by Public Health?
*
YES
NO
Have you been told to self-isolate by Public Health?
*
YES
NO
If you have answered “YES” to any of the above questions you should leave the workplace, and call 811 . Seek medical advice from your health practitioner
Submit
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