If you are human, leave this field blank.To keep Service Providers (SP), Customers and all Stakeholders safe, we are following local PHO requirements and mandating that every SP be assessed for COVID-19 symptoms and risk factors each day before starting her/his work day.Name *1. Do you have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions.Felt Feverish and/or a Documented Fever *YesNoChills *YesNoSweats *YesNoCough *YesNoShortness of Breath or Difficulty Breathing *YesNoNot Feeling Well, Extreme Tiredness, or Muscle Pain *YesNoSore Throat or Trouble Swallowing *YesNoRunny/Stuffy Nose or Nasal Congestion *YesNoNew Loss of Taste or Smell *YesNo2. Have you had close contact (less than 6 feet for at least 15 minutes) with someone with confirmed diagnosis of COVID-19 within the last 14 days? *YesNo3. Have You Travelled Internationally In The Last 14 Days? *YesNoReullts of Screening QuestionIf the SP answers NO to all questions from 1 through 3, they have passed and can proceed to appointments / work for the balance of the day. If the SP answers YES to any questions from 1 through 3, they have not passed and they should not venture outside to visit customers, to perform any services. The SP should stay home to self-isolate immediately and contact their health care provider or https://www.alberta.ca/coronavirus-info-for-albertans.aspx to find out if they require a COVID-19 test. Submit Click Here to Visit ALBERTA.CA
