Required Daily COVID19 -Health Screening

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Our workplace policies ensure that workers showing symptoms of COVID-19 are prohibited from the workplace.

You will be encouraged to work at home as much as possible and we will be limiting workers on-site to essential workers only. In order to make the work environment safe for all, please confirm that none of the following applies to you:

Have you had symptoms of COVID-19 in the last 10 days? Symptoms include fever, chills, new or worsening cough, shortness of breath, sore throat, and new muscle aches or headache. *

Yes

Have you been directed by Public Health to self-isolate? *

Yes

Have you travelled outside of the country in the last 14 days? *

Yes

Have you come into contact with anyone who has a confirmed case of COVID-19 in the last 14 days? *

Yes

You are aware that no visitors are allowed on set or in the production office? *

Yes

You are aware of the risks involved in providing your services amidst the COVID-19 Pandemic and you hereby voluntarily agree to participate in the production with full knowledge, appreciation, and understanding of the dangers and personal risks involved. *

Yes

What production are you completing this form for? *

Name: *

Phone *

Email: *

Date: *

YYYY

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