COVID-19 Health Declaration

COVID Health Declaration for returning to the office

COVID-19 Health Declaration

In response to the recent Coronavirus (COVID-19) pandemic, the health and well-being of you, your family and our company is our highest priority.

In order to gain access to our work site please confirm the following:

  • I am feeling healthy overall today.
  • I do not currently have any symptoms of COVID-19 (fever, chills, cough, sore throat, muscle aches, severe exhaustion/weakness or shortness of breath.).
  • I have not had a fever of 38°C / 100.4°F or greater within the past 72 hours.
  • I agree to respect physical distancing while on site today.

During the previous 14 days I have not:

  • Been advised to self-isolate or quarantine by a doctor or health authority.
  • Traveled outside of the country.
  • Provided direct care for a COVID-19 case*.
  • Lived in the same household as a COVID-19 case.
  • Had direct physical contact with a COVID-19 case (e.g. shaking hands) *.
  • Had direct contact with infectious secretions of a COVID-19 case (e.g. being coughed on, touching used paper tissues with a bare hand) *.
  • Had face-to-face contact with a COVID-19 case within 2 m and > 15 minutes*.
  • Been in a closed environment (e.g. classroom, meeting room, hospital waiting room, etc.) with a COVID-19 case for 15 minutes or more, at a distance of less than 2 m*.
  • Worked in a laboratory handling specimen from a COVID-19 case.
  • Had contact in an aircraft sitting within two seats (in any direction) of a COVID-19 case.
  • Had face-to-face contact (within 2 m and > 15 minutes) with any person who was symptom free but developed COVID-19 within 48 hours of our contact.

*Healthcare workers wearing appropriate PPE are exempt.

I cannot think of any reason I should not be allowed access to the work site today.

 

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