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Contact at the company: (required)
Purpose of the visit:
Akler Browning LLP has implemented a health and safety plan for operation in alignment with local Public Health Guidelines, Health and Safety regulations, and any applicable legislation in Ontario. To ensure the safety of our employees, all individuals visiting our premises at 700-5255 Yonge Street, Toronto must complete the following screening questionnaire. We appreciate your cooperation in sharing this information as strives towards creating a safe environment for all employees and visitors.
Symptoms should not be chronic or related to other known causes or conditions. For individuals who are 18 years of age and older.
This can be because of an outbreak or contact tracing.
If you have since tested negative on a lab-based PCR test, select “No.”
If public health has advised you that you do not need to self-isolate (e.g., you are fully vaccinated* or another reason), select “No.”
Fully vaccinated is defined as an individual ≥14 days after receiving their second dose of a two-dose COVID-19 vaccine series or their first dose of a one-dose COVID-19 vaccine series.
If you are fully vaccinated or have already gone for a test and got a negative result, select “No.”
If you are fully vaccinated, select “No.”
If the individual experiencing symptoms received a COVID-19 vaccination in the last 48 hours and is experiencing mild headache, fatigue, muscle aches, and/or joint pain that only began after vaccination, select “No.”
If you answered NO to all questions from 1 through 7 you may enter the workplace.
If you answered YES to any questions from 1 through 7 you must not enter the workplace, inform your contact at Akler Browning of the result and stay home and contact your healthcare provider or Telehealth Ontario to get advice.
If you answered YES to question 7 you must stay home, along with the rest of the household, until the sick individual gets a negative COVID-19 test result, is cleared by your local public health unit or is diagnosed with another illness.
Upon visiting the workplace, you expressly agree to abide by all Health and Safety measures implemented by Akler browning LLP.
Please submit this form prior to physically vising the Akler Browning LLP by clicking the submit button below.
I attest that the information above is accurate. I agree to abide by the procedures outlined above.
Signature: (required). Draw with your mouse or finger (touchscreen only).