AMG | Advance Marble & Granite Ltd. -Homeowners -  Daily COVID Screening
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Email *
Name of Customer: *
Reason for Visit: *
Location *
If you are fully vaccinated and not immune compromised and experienced the symptom(s) over 5 days ago and the symptom(s) have been improving for over 24hours (48 hours for gastrointestinal symptoms) and you do not have a fever, select “No.”
If you are unvaccinated or immune compromised and experienced the start of symptom(s) over 10 days ago and the symptom(s) have been improving for over24 hours (48 hours for gastrointestinal symptoms) and you do not have a fever, select “No”.
If you are symptomatic and tested negative for COVID-19 on a single PCR test or two rapid antigen tests (RAT) taken 24-48 hours apart and symptoms have been improving for over 24 hours (48 hours for gastrointestinal symptoms) and you do not have a fever, select “No”.
For symptom(s) that are new, worsening or different from an individual’s baseline health, select “Yes”. Otherwise, symptom(s) should not be chronic or related to other known causes or conditions. The symptoms listed here are the symptoms most commonly associated with COVID-19. If you have these symptoms, you should isolate and contact your health care provider, take a self-assessment, visit a clinical assessment centre, or call Telehealth Ontario (1-866-797-0000) to get advice or an assessment, including if you need a COVID-19 test, if eligible.
1.  In the last 10 days have you experienced any of the symptoms below? *
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2. In the last 10 days have you experienced any of the symptoms below? *
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3. In the last 14 days, have you travelled outside of Canada AND been advised to quarantine (as per the federal quarantine requirements)? *
4. Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? *
Staying at home/self-isolation can be because of an outbreak or contact tracing.
5. In the last 10 days, have you tested positive for COVID-19? *
If you are fully vaccinated and not immune compromised and the test was more than5 days ago, select “No”. This includes a positive COVID-19 test result on a lab-based PCR test, rapid antigen test or a home-based self-testing kit
6. Do any of the following apply?
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7. In the last 10 days, have you been identified as a “close contact” of someone who currently has COVID-19 and doesn’t live with you?
If you are fully vaccinated and not immune compromised, select “No”.  If you tested positive for COVID-19 (on a lab-based PCR test, rapid antigen test, or home-based self-testing kit) within the last 90 days and have already completed your isolation period, select “No”
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If the worker answered “No” to all questions from 1 through 7, they can enter the workplace. In the workplace, the worker must continue to follow all public health and workplace control measures, including masking, maintaining physical distance and hand hygiene, where applicable.                o A worker returning to the workplace after self-isolating for any reason must wear a surgical/procedure mask for 10 days (from their isolation days) at all times even if not otherwise required to do so, subject to limited exceptions†. Their mask may only be removed to consume food or drink and they must remain at least two metres away from others when their mask has been removed.                 o In addition to following all the workplace’s regular control measures, if the worker has received a COVID-19 and/or flu vaccination in the last 48 hours and has mild fatigue, headache, muscle ache and/or joint pain that only began after immunization, and no other symptoms, the worker must wear a surgical/procedure mask for their entire shift at work even if not otherwise required to do so, subject to limited exceptions. Their mask may only be removed to consume food or drink and they must remain at least two metres away from others when their mask has been removed. If the symptoms worsen, continue past 48 hours, or if they develop other symptoms, they should leave work immediately to self-isolate.
If the worker answered “Yes” to any questions from 1 through 7, they must not enter the workplace (including any outdoor or partially outdoor workplace). They should inform their employer of this result and go or stay home to self-isolate immediately and contact their health care provider, take the self-assessment, visit a clinical assessment centre, or call Telehealth Ontario (1-866-797-0000) to get advice or an assessment, including if you need a COVID-19 test, if eligible.
If the worker answered “Yes” to question 1 the worker must stay home and be informed that:       • If the worker is fully vaccinated and not immune compromised, they must self isolate for 5 days from when symptom(s) started and stay in isolation until their symptom(s) have been improving for over 24 hours (48 hours for gastrointestinal symptoms) and they have no fever.
If the worker is not fully vaccinated or if they are immune compromised, they must self-isolate for 10 days from when the symptom(s) started and stay in isolation until their symptom(s) have been improving for over 24 hours (48 hours for gastrointestinal symptoms) and they have no fever
If the worker answered “Yes” to question 2 the worker must stay home and be informed that:
If the worker answered “Yes” to question 3 they must be advised to self-isolate per federal requirements. For further information workers should be encouraged to access the Government of Canada’s website.
If the worker answered “Yes” to question 4 they should be told to go or stay at home to self-isolate immediately and contact their health care provider, visit a clinical assessment centre, or call Telehealth Ontario (1-866-797-0000) to get medical advice or an assessment, including if you need a COVID-19 test, if eligible
If the worker answered “Yes” to question 5 or question 6 they must be advised to self-isolate immediately. Workers can be referred to the What to do if you’ve been exposed to COVID-19 | COVID-19 (coronavirus) in Ontario website
If the worker answered “Yes” to question 7, they must be advised to stay home for 10days after the last contact with the sick individual. Household members of the worker may go to school. child care or work, but must not leave the home for other, nonessential reasons.
If any of the answers to these screening questions change during the day, the worker should inform their employer of the change and go home to self-isolate immediately and contact their health care provider or Telehealth Ontario (1-866-797-0000) to get advice or an assessment, including if they need a COVID-19 test.
A copy of your responses will be emailed to the address you provided.
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