EMPLOYEE TRACING

SAFETY 1st, EMPLOYEE SCREENING.

Welcome team @fallnleavesTO!
Thank you for scanning in! For your safety, and the safety of our other guests, and staff, please fill out the contact tracing form prior to entering our POP UP EXPERIENCE.

REQUIRED SCREENING QUESTIONS

* Indicates required field

Name *

First

Last

DO YOU HAVE ANY OF THE FOLLOWING NEW OR WORSENING SYMPTOMS OR SIGNS? SYMPTOMS SHOULD NOT BE CHRONIC OR RELATED TO OTHER KNOWN CAUSES OR CONDITIONS *

FEVER OR CHILLS DIFFICUILTY BREATHING OR SHORTNESS OF BREATH COUGH SORE THROAT, TROUBLE SWALLOWING RUNNY NOSE/STUFFY NOSE OR NASAL CONGESTION DECREASE OR LOSS OF SMELL OR TASTE NAUSEA, VOMITING, DIARRHEA, ABDOMINAL PAIN NOT FEELING WELL, EXTREME TIREDNESS, SORE MUSCLES NONE OF THE ABOVE

HAVE YOU TRAVELLED OUTSIDE OF CANADA IN THE PAST 14 DAYS? *

HAVE YOU HAD CLOSE CONTACT WITH A CONFIRMED OR PROBABLE CASE OF COVID-19? *

Submit