Fit4Work

Instructions

At GoodLife Fitness and Fit4Less, the health and safety of our Associates, our Members and our communities is

our highest priority. Ensuring our Associates are Fit for Work through the use of standard screening questions will help protect the workplace from a potential COVID-19 outbreak. Associates are required to pass the Fit for Work Questionnaire prior to reporting to a Club or GoodLife/Fit4Less office. If at any time you choose not to complete the Fit for Work Questionnaire, you will not be permitted to attend or remain at the workplace. You will not be compensated for any missed shifts for choosing not to participate.

The information collected in the Fit for Work Questionnaire will be used and disclosed solely for the purposes of screening for fitness for work during the COVID-19 pandemic. If you fail the Fit for Work Questionnaire, or if you begin to exhibit or experience any of the symptoms outlined, you are required to inform your Manager immediately to discuss next steps.

Important Notes:

The questions below do not relate to seasonal or environmental allergies, or other pre-existing medical conditions.
If you have recently failed the Fit for Work Questionnaire but have since been cleared to return to work, the questions below relate only to a change or worsening in conditions since the date you were cleared to return.

GoodLife would like to remind you that the Fit for Work Questionnaire, Mask compliance, Physical distancing compliance from other Associates/Members, and (where applicable) Holding Members Accountable to the GoodLife Standard are all a part of the GoodLife Fitness Non-Negotiables for Safe Club Standards. For more information, please click here.

Personal Information

Report Completed By

Email

If you receive an error for email, please check for leading spaces or formatting issues.

Position

Location Information

Province

Club Name

Alberta

Club Name

British Columbia

Club Name

Manitoba

Club Name

New Brunswick

Club Name

Ontario

City

Club Name

PEI

Club Name

Saskatchewan

Club Name

Nova Scotia

Club Name

Newfoundland & Labrador

Department

Questionnaire

	Yes	No
Have you tested positive for COVID-19 on a PCR or Rapid Antigen Screening test, or have you otherwise been directed by Public Health to self-isolate or quarantine? Only consider test results for which you have not already been cleared by Public Health.
Do you have a temperature of 38 C (100.4 F) or higher?
Are you currently experiencing any of the following cold or flu-like symptoms? Consider any that are new, worsening, and not related to other known causes or conditions you already have (i.e. seasonal allergies). Symptoms include fever (temperature over 100.4 F / 38 C), sore throat, respiratory illness, difficulty breathing, difficulty swallowing, shortness of breath, chills, muscle aches, headache, sweats, lightheadedness, runny nose, diarrhea, unexplained loss of appetite, small red or purple spots on hands and/or feet, feeling fatigued, conjunctivitis (pink eye), loss of taste or smell.
Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms? If you have recently failed the Fit for Work Questionnaire but have since been cleared to return to work, the question above relates only to a change in conditions since the date you were cleared to return.
Within the last 14 days, have you returned from travel outside of Canada that requires you to self-isolate?
Within the last 14 days, have you returned from inter-provincial travel that requires you to self-isolate?
Have you been in contact with anyone who has contracted or presumed to have contracted COVID-19 in the past 14 days? If you have recently failed the Fit for Work Questionnaire but have since been cleared to return to work, the question above relates only to a change in conditions since the date you were cleared to return.
In the last 10 days, have you tested positive on a rapid antigen test or home-based self-testing kit? If you have since tested negative on a lab-based PCR test, select "No."
In the last 14 days, have you received a COVID Alert exposure notification on your cell phone? If you are fully vaccinated (it has been more than 14 days since your final dose of either a two-dose or one-dose vaccine series) select “No”. If you already went for a test and got a negative result, select “No”

Expand: Close Contact

Close contact is defined as a person who provided care for an individual, including healthcare workers, family members or other caregivers, or who had other similar close physical contact (i.e. intimate partner) (within 2 metres) with the person without consistent and appropriate use of personal protective equipment;

OR who lived with or otherwise had close prolonged contact (within two metres for more than 15 minutes) with the person while they were infectious;

OR had direct contact with infectious bodily fluids of the person (e.g. was coughed or sneezed on) while not wearing recommended personal protective equipment.

*Note: reference to ‘the person’ refers to the individual who has contracted the virus in which you have been in close contact with.

You have selected YES. Please read the following instructions:

The Fit4Work Questionnaire is designed to broadly apply provincial rules related to COVID-19 risk factors. To confirm your next steps, please refer to the COVID-19 Self-Assessment Tool available through your Provincial Health authority, or follow direction provided to you by your local Public Health unit.

If it is determined that you do not need to self-isolate or get tested, you are permitted to attend work. Contact your Manager to confirm that you failed the Fit for Work Questionnaire but have been cleared to attend work today.

If it is determined that a self-isolation period or COVID-19 test is required/recommended, please take this advice and act accordingly. To return to work, GoodLife will require completion of the self-isolation period and/or proof of a negative test (including verbal confirmation). Contact your Manager immediately to advise that you have not been cleared to attend work today and to discuss available options.