Simcoe & District Chamber of Commerce

At Simcoe & District Chamber of Commerce, we concentrate our efforts on preventing the spread of the novel coronavirus (COVID-19) following the World Health Organization's COVID-19 outbreak guidelines

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1

What is your full name? To keep you informed in the event a COVID-19 positive case is detected in our premises.

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Your full name must contain at least 3 characters

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2

What is your phone number? To keep you informed in the event a COVID-19 positive case is detected in our premises.

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3

What is your email address? To keep you informed in the event a COVID-19 positive case is detected in our premises.

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4

In the last 2 weeks, have you experienced any of these symptoms? Fever, shortness of breath, dry cough, tiredness, or any other COVID or flu symptom?

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5

In the last 14 days, have you been in close contact or exposed to any person suspected of or confirmed with COVID-19?

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6

Have you taken an international or domestic flight within the last 14 days?

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7

Declaration and Data Privacy Consent Form

By submitting this form, I declare that the information I have given is true, correct, and complete. I am aware that I may be held liable for knowingly providing incorrect information.

I also voluntarily and freely consent to the collection and sharing of the above personal information only in relation to COVID-19 measures, in accordance with the Data Privacy Act.

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