COVID-19 Residential Screening Form

COVID-19 Screening Form

Please note that Bear Cleaners & Supply will only use your personal information to contact you about your cleaning needs. We will never share your information with a third party. Thank you for choosing Bear Cleaners & Supply.
Name*

First NameLast Name
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COVID-19: No Contact Cleaning
Due to current COVID-19 restrictions, Bear Cleaners & Supply are offering no contact cleaning only.
1. Please ensure that our technicians can safely access each area without any contact with household members.
2. Please remove small furnishings and personal items from each area that requires carpet cleaning.
3. If you are moving larger furniture yourself, please ensure that this is done before our technicians arrive.
4. If our technicians are moving furniture, please ensure that small items and china are removed from cabinets and drawers so we can safely move large furniture.
5. As much as we love your furry friends, please ensure your pets are kept safely in a separate room away from the work areas.
COVID-19 Screening Questions

You know the drill by now - to ensure the safety of your household and our staff, please answer the COVID-19 screening questions.
In the last 14 days, have you or anyone in your household (not including asymptomatic rotational workers):
- Traveled outside of Newfoundland and Labardor?
- Been in close contact with a known or suspected case of COVID-19?
- Been in close contact with a person suffering from acute respiratory illness who has travelled outside of the province within 14 days prior to illness onset?
- Had two or more of the following symptoms (new or worsening):
  - Fever (or signs of a fever, such as chills, sweats, muscle aches, and lightheadedness);
  - Cough;
  - Headache;
  - Sore throat;
  - Runny nose;
  - Painful swallowing;
  - Diarrhea;
  - Loss of sense of smell or taste;
  - Unexplained loss of appetite;
  - Small red or purple spots on hands and/or feet?
None of the above conditions apply to myself or anyone in my household.One or more of the above conditions apply to myself or someone in my household (not including asymptomatic rotational workers)
Should be Empty:

COVID-19 Screening Form

COVID-19: No Contact Cleaning

COVID-19 Screening Questions