YOUR DAILY
SELF ASSESSMENT
FORM

Please read our Back to Work Covid-19 Guide and complete the following registration and COVID-19 Self-Assessment, to assist us in any future contract tracing needs.

Updated April 28, 2021

  • MM slash DD slash YYYY
  • Ask the guest:
    1. "Are you exhibiting any COVID-19 Symptoms such as fever, chills, repeated shaking with chills, muscle pain, headache, sore throat, new loss of taste or smell?"
    2. "Have you travelled in the past 14 days outside of Canada, or have you been in contact with anyone in the past 14 days who may have travelled or had a positive case of COVID-19?"
    A "yes" to any of the questions asked will not permit the guest to enter.
    How did the guest answer the above questions?
  • Has the guest's vaccine status been checked?
    Has the guest's ID been checked and matched to the vaccine receipt?
    Type YES once the above two items have been confirmed
    If you need help verifying documents, see this link
  • This field is for validation purposes and should be left unchanged.