Coronavirus Symptom-free Confirmation

Coronavirus Symptom-free Confirmation

To be completed by all customers prior to entering the Zonas store as per Ontario Government Health Protocols.
I confirm that:

1. I or a member of my household are not experiencing any of the following symptoms:
- Fever
- Chills
- Cough
- Shortness of breath
- Sore throat and painful swallowing
- Stuffy or runny nose
- Loss of sense of smell
- Headache
- Muscle aches
- Fatigue
- Loss of appetite
2.      I or a member of my household have not returned from travel outside Canada within the last fourteen days.

3.      I or a member of my household have not been directed to quarantine or self-isolate by a public health official.

4.      I confirm that I am aware that Zona’s staff will have to be closer that 2 meters in order to provide services.
If you cannot confirm the above information you must not attend at Zona’s store and should contact Michael Barker at 905.830.9737 to discuss next steps.
Name

First Name Last Name
Phone Number
Please enter a valid phone number.
Email
example@example.com
Should be Empty: