Health Nexus COVID-19 Pre-Screening Form

This completed form will be sent to Katerina Firlova, Manager Strategic Partnerships and Operations (Interim) for review.

If any items of the above has not been checked off, you will not be permitted to report to work at the WeWork 240 Richmond Street West office and must self-isolate for 14 days.

If you experience any symptoms, you should contact the appropriate health authority to determine how to seek medical care safely.

If all of the above items have been checked off, you may proceed to work. If you begin to experience symptoms during working hours, please report to Katerina Firlova, Manager Strategic Partnerships and Operations (Interim) immediately.

If you experience any symptoms, you should contact the appropriate health authority to determine how to seek medical care safely.

This is a reminder to adhere to the safe distancing rules, wear your required personal protective equipment, and practice safe hygiene.