KYC COVID-19 Contact Tracing Form

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This form must be completed prior to accessing the KYC property.

Before continuing, please complete an Ontario COVID-19 Screening questionnaire before completing this form:

Customer/Member Screening: https://covid-19.ontario.ca/screening/customer/

Staff & Volunteer Screening: https://covid-19.ontario.ca/screening/worker/

Name *

Member Number (or phone number if visitor) *

Today's Date *

YYYY

Planned timeframe to be on KYC property *

Purpose of visit *

Ontario COVID-19 screening

I have completed the Ontario COVID-19 screening tool, with a successful result, valid to today's date *

Yes

You are not permitted to access KYC property unless you completed Ontario COVID-19 screening tool, with a successful result, valid to today's date

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