RHPL COVID-19 Screening

Anyone entering a City of Richmond Hill facility must fill out this screening form. The information will be used for contact tracing purposes.

The personal information on this form is collected under the authority of the Municipal Act, 2001, S.O. 2001, c. 25 and/or the Personal Health Information Protection Act, S.O. 2004, c. 3, Schedule A. The information will be used in the administration, management, safety, security and protection of City staff and the public in efforts to mitigate against the spread of COVID-19. Information may be disclosed to the Regional Health body in the event of a Contact Tracing request, or other bodies as required for the safety, security and protection of City staff and the public as a result of a COVID-19 exposure. Questions about this collection can be directed to the City of Richmond Hill - Human Resources, 225 East Beaver Creek Road, 2nd Floor, Richmond Hill Ontario L4B 3P4, by telephone at 905-771-8800 or by email to hr@richmondhill.ca.

COVID-19 Symptoms and Signs can include:

• 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

Symptoms should not be chronic or related to other known causes or conditions.

Additional Information:

• COVID-19 is spread through the air by infectious droplets when someone coughs, sneezes or spits when they talk.
• To prevent the spread of COVID-19, maintain a physical distance of at least 2 metres (6 feet) from others and use a mask or face covering where this is not possible.
• Wash your hands often with soap and water or use an alcohol-based hand sanitizer and increase how often you clean and disinfect commonly touched surfaces.