Protecting you from Covid-19..... together!

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1. Wash your hands often with soap and water or alcohol-based hand sanitizer.
2. Sneeze and cough into your sleeve.
3. If you use a tissue, discard immediately and wash your hands afterward.
4. Avoid touching your eyes, nose or mouth.
5. Avoid contact with people who are sick.
6. Stay home if you are sick.
7. Avoid high-touch areas, where possible, or ensure you clean your hands after.
8. Where possible, wear gloves when interacting with high-touch areas. Do not touch your face with gloved hands. Take care when removing gloves. Ensure you wash your hands after removing them.
9. Wash your clothes as soon as you get home.
10. If you are ill: notify your supervisor immediately, complete the self-assessment and follow the instructions you get.
11. Travel to and from Job site alone. Do not sit together in vehicles during breaks.
12. Do not share tools
13. Anyone who travels from site to site is at a heightened risk for transmitting Covid 19, Attempt to remain with the same crew or sites. If you are someone that moves between sites use extreme precautions. Deliveries from suppliers, should be curbside or all workers need to remove themselves from site during delivery.
14. Maintain physical distancing whenever possible.
15. Avoid congregating with others on site.

Note: You are to use this form for each site you visit. Supervisors will ensure that each person has completed this form for their site.

Name of Company You Work For: *

Do you understand the job site rules? *

Job site rules are posted at all sites, it is your responsibility to read them before entry!

Yes I have read and understand the site rules.

Required

Your name, first and last *

Location(s) you will be working at today (lot # & street name) *

If you are NOT scheduled you will remain off property until invited.

Are you well? *

Yes I am well, I don't have a fever, cough or trouble breathing

I am not feeling well

Are the people you live with well? *

Check one!

Yes everyone in my household is well, nobody has a fever, cough or trouble breathing

There are some in my family who are not feeling well

Note: I will share with family members the extreme precautions construction sites are providing to ensure I stay safe and can continue working!

Is your household following guidelines to prevent Covid-19 exposure? *

Check if you are following Health Canada measures at home.

Yes, we are following all rules as best we can

Required

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