• Name*
  First Last
• Phone*
• Email*
• Department*
  • Sales
  • Services
• Do you have any of the following: Fever - Cough - Shortness of Breath - Sore Throat - Runny Nose - feeling unwell?*
  • No
  • Yes
• Have you been in close contact with someone who is sick or has confirmed COVID-19 in the past 14 Days?*
  • No
  • Yes
• Have you returned from travel outside of Canada in the past 14 days?*
  • No
  • Yes

• If you answered YES to any of these questions, go home & self-isolate right away. Call Telehealth or your health care provider.

Δ