• Complete this form and submit it prior to entering our greenhouse facility for your work shift. If you answer Yes to any of the questions below, DO NOT ENTER OUR WORKPLACE. You should immediately contact both your Supervisor and Human Resources. Stay home and self isolate immediately. Contact your health care provider or public health to get advice or an assessment including if you need a COVID-19 test. You may not return to work until cleared by the Human Resources Manager.

  • If you answered NO to all five questions, then you may enter the workplace. In the workplace you must continue to follow all public health and workplace control measures including masking, physical distancing, and hand hygiene.

  • MM slash DD slash YYYY
  • :
    (Only answer "YES" to this question if it is a NEW or unusual symptom and not related to getting a COVID-19 vaccine in the last 48 hours or other known cause(s) or condition(s) you already have like allergies, asthma, COPD, etc).
  • Check those that apply.
    (This could be because of an outbreak or contact tracing.)
    (If you have been identified as a close contact and have been fully vaccinated, you must first contact public health to review. If they do not advise you to self-isolate, then you may select "NO".)
    (If exempt from federal quarantine requirements because you are fully vaccinated and have met specific conditions, or an essential worker who crosses the Canada-US border regularly for work, select "No".)
    (If you are fully vaccinated and it has been 14 days or more since your final dose of either a two-dose or a one-dose vaccine series, select "No". If the person got a COVID-19 vaccine in the last 48 hours and is experiencing a mild headache, fatigue, muscle aches, and/or joint pain that only began after vaccination, select "No".)
  • If you answered YES to any of these questions:

    DO NOT ENTER OUR WORKPLACE, go home or stay home and self-isolate right away. Call your health care provider or the COVID-19 Info-Line at (905) 688-8248 and a public health professional will give you detailed instructions to follow to protect you, your family and members of the public.
  • If you answer yes to question 5. (meaning you are not fully vaccinated):

    You must stay home along with the rest of your household until the sick individual obtains a negative COVID-19 test and gets cleared by a health professional OR are diagnosed with another illness.
  • If you are not fully vaccinated and live with someone who has travelled outside of Canada (but you did not):

    You are still permitted to go to work but must otherwise stay home except for essential reasons (school, childcare, work and essential errands).
  • If the answer to these questions changes at any point during the day:

    You must go directly to the designated sick room or your car and inform your supervisor or Human Resources immediately. Go home to self isolate immediately and contact your health care provider or public health to get advice on an assessment including a COVID-19 test. You may not return to work until cleared by Human Resources.