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COVID SCREENING SURVEY

Survey to screen individuals prior to entering SCC site

SCC is currently taking measures to ensure your safety, the safety of our staff and limit the risk of infection. To help us prevent the spread of COVID-19, we ask you to read this carefully and answer the questions below. Please act accordingly following the screening questions.

For questions about symptoms, please refer to the list of symptoms in the box below. If 'yes' is answered to any of questions 1-4, do not enter the site, contact your manager (employees only) and the local public health authority.

There are 4 questions in this survey.

COVID-19 Screening

(This question is mandatory)

Are you experiencing any symptoms?

  1. Examples of symptoms include the new onset of:
    • a new or worsening cough
    • shortness of breath or difficulty breathing
    • temperature equal to or over 38°C
    • feeling feverish
    • chills
    • fatigue or weakness
    • muscle or body aches
    • headache
    • new loss of smell or taste
    • gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
    • feeling very unwell
Choose one of the following answers
(This question is mandatory)

Has anyone in your household experienced any symptoms in the past 14 days? (Note: if the symptomatic person in your household has received a negative COVID-19 test result, please answer 'no') 

Choose one of the following answers
(This question is mandatory)

In the past 14 days, have you been identified as a close contact of someone with suspected or confirmed COVID-19?

Choose one of the following answers
(This question is mandatory)

Have you travelled outside Canada in the past 14 days or been in contact with anyone who has travelled outside Canada in the past 14 days?

Choose one of the following answers