JavaScript non è attivato nel tuo browser, pertanto questo file non può essere aperto. Attivalo e ricarica.
COVID-19 Disclosure & Consent
In response to the recent COVID-19 Pandemic, the health and well-being of you, your family and our team is our highest priority. It is important that we understand some things about you, in order to best serve you during this unprecedented time.
Please confirm the following.
Accedi a Google
per salvare i risultati raggiunti.
Scopri di più
* Indica una domanda obbligatoria
Are you or anyone in your house currently positive of COVID-19?
*
Yes
No
Have you or anyone in your house returned to Alberta from any country outside of Canada whether by car, air, bus or train in the past 14 days?
*
Yes
No
Have you or anyone in your house been identified as a contact of someone who has tested positive for COVID-19?
*
Yes
No
Do you, or anyone in your house, currently have any of the following symptoms of COVID-19 (flu-like symptoms, fever, chills, cough, sore throat, runny nose, muscle aches, severe exhaustion / weakness, shortness of breath, difficulty breathing.)
*
Yes
No
If you have answered YES to any of the above, any in-person meeting and services cannot be facilitated.
By submitting this consent form, I verify the information I have provided is truthful and accurate. I knowingly and willingly consent to have in-person meeting and/or services completed during this time. I understand that some services are to be done inside my property and I allow the home builder staff and trades access inside my property as necessary.
First Name, Last Name
*
La tua risposta
Property Address
*
La tua risposta
Date
*
GG
/
MM
/
AAAA
Email Address
*
La tua risposta
Please notify us after you have successfully filled out the form. Thank you.
Invia
Cancella modulo
Non inviare mai le password tramite Moduli Google.
Questi contenuti non sono creati né avallati da Google.
Segnala abuso
-
Termini di servizio
-
Norme sulla privacy
Moduli