Employee Screening Form
The purpose of this Screening Tool is to help you make decisions about whether you should attend school or go to work.
This screening tool should be completed daily before attending school or work. No personal information is requested when completing the tool, which means that you cannot be personally identified or linked to your responses. Using this tool is voluntary. It is recommended that you contact a healthcare provider if you have more questions about your health. This tool is subject to change as further guidance from the Ministry of Health and evidence related to COVID-19 risks becomes available.
Please note: A variety of factors (including underlying health conditions) can increase the risk of serious illness from COVID-19, and general guidance may not always apply well to individual situations. Every individual needs to take into account their personal risk factors when deciding whether it is safe for them to attend or work in a particular place. OPH recommends the CDC website to all persons wishing to better understand their personal risks from COVID-19 infection.
Check the note at the bottom of the form prior to submission to see whether you should stay home or come to work/school, based on your answers.