CONTACT INFORMATION *

1. DO YOU HAVE ANY OF THE FOLLOWING NEW OR WORSENING SYMPTOMS OR SIGNS?
SYMPTOMS SHOULD NOT BE CHRONIC OR RELATED TO OTHER KNOWN CAUSES OR CONDITIONS*

• Fever or chills
• Difficulty breathing or shortness of breath
• Cough
• Sore throat, trouble swallowing
• Runny nose/stuffy nose or nasal congestion
• Decrease or loss of smell or taste
• Nausea, vomiting, diarrhea, abdominal pain
• Not feeling well, extreme tiredness, sore muscles

2. HAVE YOU TRAVELED OUTSIDE OF CANADA IN THE PAST 14 DAYS?*

3. HAVE YOU HAD CLOSE CONTACT WITH A CONFIRMED OR PROBABLE CASE OF COVID?*

* Mandatory Fields
NOTE: If you have answered yes to any of the questions above, you are prohibited from entering any of Mason Homes job sites, head office or the design studio and should contact a physician.