Health Screening

Valecraft Homes COVID-19 Preventative Measures

This form has been created for all trades and employees that work at any job site managed by Valecraft Homes. The completion and submission of this form are mandatory daily for attendance at our job sites. This enhanced screening will ensure that we are creating a healthy and safe environment for all team members onsite.

 

QUESTIONNAIRE TO BE COMPLETED BY ALL TRADES & EMPLOYEES PRIOR TO ENTERING A VALECRAFT SITE

Trade & Employee Health Screening

  • LOCATION - Which location are you working at today?
  • HOUSE or HEAD OFFICE- What house/lot# are you working on today? If it's Head Office, put office.
  • EMPLOYER - Your employer/company

  • 1) In the last 14 days, have you travelled outside of Canada?
  • 2) Do you currently have any of the following symptoms:
    • fever (over 37.8° C) • cough or barking cough (croup) • shortness of breath • sore throat • difficulty swallowing • runny or stuffy/congested nose • decrease or loss of taste or smell • pink eye • digestive issues like (nausea/vomiting, diarrhea, stomach pain) • unusual muscle aches • extreme tiredness falling down often
  • 3) Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?
  • 4) In the last 14 days, have you been identified as a “close contact” of someone who currently has COVID-19?
  • If you answered YES to questions 1, 2,3 or 4 please DO NOT come on site. Please complete the Ontario Public Health’s Self Assessment Questionnaire and follow their direction.

  • YOUR FULL NAME
  • YOUR EMAIL ADDRESS
  • YOUR PHONE NUMBER
  • If the information noted on this form at the time of submission should change, please advise the Site Supervisor or Manager immediately.
  • This field is for validation purposes and should be left unchanged.