Staff Daily Health Check

As per the Public Health Order issued November 19th, 2020 by the Provincial Health Officer Dr. Bonnie Henry, and WorkSafe BC guidelines, all BC employers are required to ensure that every worker performs a daily health check before entering the workplace. Health checks are mandatory self-assessments conducted by workers that include confirming with their employer that they have reviewed the complete list of entry requirements and that none of the prohibited criteria apply to them.

Please complete and submit the form below every day prior to coming in to the workplace. If you are working from home, you do not have to submit the form.

Date Submitted *

Month

Day

Year

Name *

Have you travelled outside of Canada within the last 14 days? *

Yes

Have you been identified by Public Health as a close contact of someone with COVID-19? *

Yes

Have you been told to isolate by Public Health? *

Yes

Are you experiencing ANY of the following new or worsening symptoms: * fever/chills * extreme fatigue/tiredness * cough * headache * loss of sense of smell/taste * body aches * difficulty breathing * nausea/vomiting * sore throat * diarrhea * loss of appetite *

Yes

If you answered "Yes" to any of the questions above, please do not enter the workplace and report your absence due to illness as directed in the staff safety plan

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