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COVID-19 Symptom reporting form 

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Bloc formulaire

The Public Health Agency of Canada (PHAC) assesses a real public health hazard associated with COVID-19 for Canada.

To this end, Les Entreprises A&R Brochu (Const.) Inc. must take preventive measures to ensure the health and safety of all its employees, visitors and their entourage as well as the work environment at 1505 rue Marie-Victorin in Saint-Bruno-de-Montarville.

 

We ask you to answer this questionnaire in order to assess that your presence is safe for the project and to submit this form to the Health and Safety (OHS) manager, or to the superintendent.

 

Anyone present at the site must fill out this form every day before the start of their working day.

 

 
Fields marked with an asterisk are required.
 

Select the reason of your presence


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