Covid-19 Pre-Work Screening Tool Name* First Last Person I report to directly (Group Lead, Supervisor, Manager etc.)*Select oneCasting – Ian NunnCasting – Isaac BalouCDC – Mike MorrisonCDC – Mike ThompsonCDC / Value Add – Dave ThomsonCDC - Dan DillionCDC - Peter NoelCDC - Trevor GregoryConverting – Jason PattisonCopper Zone - Darren KuzmaCopper Zone - David WilsonCopper Zone - Dennis SmithCopper Zone - Matt PortissCopper Zone - Scott MacDonaldExtrusion - Joe WatsonExtrusion - Tyler McQuarrieExtrusion - Wayne BreaultMaintenance - Chris DelineMaintenance – Darryl HallMaintenance - Marty SturgeonMaintenance - Pat WoodsMaintenance – Scott McGuganMaroon Zone - Lindsay McClureMaroon Zone – Phil WalshMaroon Zone - Sean WatsonProduction – Mark ArmstrongProduction – Rob DohertyShipping – Doug FennTool Control - Jason PattisonWeekend – Dave WilsonWeekend – Jake IrsagWeekend – Paul NolanWhite Zone - Gerry RokeWhite Zone -Jeff WaghornWhite Zone -John FurtadoWhite Zone -John RamseyFinance – Bozena SazonFinance – Laurie MorrisonFinance – Vivian KokGM – Kent SchenkHR – Suzanne JaekelIT – Tim TurnbullOperations – Phil BuckmanPurchasing – Gaurav SharmaQuality – Jason BrownSales – John DermodySales – Pierre GravelSales – Steve WasylykWorking Hours*Select one1st Shift (Midnight – 08:00 or similar)2nd Shift (08:00 – 16:00 or similar)3rd Shift (16:00 – Midnight or similar)Casting Days (07:00 – 19:00)Casting Nights (19:00 – 07:00)Weekend Days (12:00 – Midnight)Weekend Nights (Midnight – 12:00)Days (07:00 – 15:00 or similar)Have you travelled outside Canada in the last 14 days?*I have NOT travelled outside Canada in the last 14 daysI HAVE travelled outside Canada in the last 14 daysDo you have any symptoms associated with COVID-19? (These include fever, chills, difficulty breathing, shortness of breath, cough, sore throat, trouble swallowing, runny nose, stuffy nose, nasal congestion, loss/decrease of smell, loss/decrease of taste, nausea, vomiting, diarrhea, stomach pain, tiredness, headache, pink eye, sore muscles and a general unwell feeling)*I do NOT have any of the above symptomsI DO have one or more of the above symptomsHave you been exposed to someone with a confirmed or probable case of COVID-19?*I have NOT been exposed to someone with a confirmed or probable case of COVID-19I HAVE been exposed to someone with a confirmed or probable case of COVID-19Is a member of your immediate household awaiting a COVID-19 test or test result, except for the purposes of visiting a long-term care home?*NO, no-one in my immediate household is awaiting a COVID-19 test or test result (except to be allowed to visit a long-term care home)YES, someone in my immediate household is awaiting a COVID-19 test or test result (other than to be allowed to visit a long-term care home)
