COVID-19 Customer Screening
Your personal details
First Name
Last Name
Email
Address
City
Province
Postal/Zip Code
Primary Phone
COVID-19 Screening
Do you have new or worsening symptoms or signs of fever or chills?
Yes
No
Do you have new or worsening symptoms or signs of a cough?
Yes
No
Do you have new or worsening symptoms or signs of runny nose/stuffy nose or nasal congestion?
Yes
No
Do you have new or worsening symptoms or signs of nausea, vomiting, diarrhea, abdominal pain?
Yes
No
Have you travelled outside of Canada in the past 14 days?
Yes
No
Do you have new or worsening symptoms or signs of difficulty breathing or shortness of breath?
Yes
No
Do you have new or worsening symptoms or signs of sore throat, trouble swallowing?
Yes
No
Do you have new or worsening symptoms or signs of decrease or loss of smell or taste?
Yes
No
Do you have new or worsening symptoms or signs of not feeling well, extreme tiredness, sore muscles?
Yes
No
Have you had close contact with a confirmed or probable case of COVID-19?
Yes
No
What Department or Sales Executive Are You Here To See?
Service
Parts
SalesGeneral
Sales Manager George or Scott
Finance Manager Lorrie or Michelle
Sales-Jerry
Sales-Daniel
Sales-Leslie
Sales-Victor
Sales-Erica
Sales-Cherry
Sales-Bill
Sales-Paul
Sales-Alain
Sales-Tyler
Sales-Wendy
Sales-Unsure
OtherPlease Let Reception Know
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