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Covid-19 Health Declaration

TO BE COMPLETED EVERYDAY PRIOR TO REPORTING TO YOUR SHIFT(S)

(ONLY REQUIRED ONCE A DAY)

1. Are you currently experiencing any of these symptoms?

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Stay home

and self-isolate

+

Call your manager and contact a health care provider

2. Does anyone in your household have one or more of the above symptoms?

3. Have you been notified as a close contact of someone with covid-19 or been told to stay home and self-isolate?

4. In the last 14 days, have you or anyone in your household travelled outside of Canada?

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Stay home

and self-isolate

+

Call your manager and contact Public Health (Porcupine Health Unit)

Thank you for submitting!

If you have any questions or concerns please contact admin@rnlclean.ca or 705-367-0379.