COVID Self-Declaration

COVID-19 Self-Declaration

Phone: 604-762-8834

Address: #800 15355 24 Avenue, Surrey BC V4A 2H9

Address(Required)
Do you have any of the following symptoms?
Fever(Required)
Cough(Required)
Shortness of breath(Required)
Sore throat(Required)
Runny nose(Required)
Feeling unwell(Required)
Have you had close contact with anyone with respiratory illness or a confirmed or probable/suspected case of COVID-19?(Required)
Have you travelled or had close contact with anyone who has travelled in the last 14 days?(Required)
I certify that the information provided here is true(Required)

This waives Archstone & or (sub) contractor(s) from any liability.