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Welcome to InTrend Mortgage

1550 16th Ave, Building C North,
Richmond Hill, ON L4B 3K9
905-780-8988
113 Main Street North,
Markham, ON L3P 1X9M
905-780-8988

Help stop the spread of COVID-19.

  • If you are sick, please stay home
  • Proper face coverings are required at all times
  • Maintain physical distancing (at least 2 metres)
  • Use the hand sanitizer station when entering the building
  • Follow all safety instructions and signage at all times

Risk Assessment Form

Please complete this Covid-19 safety screening form each time you request entry into our facility.
Name(Required)
Hidden
Location(Required)
I am(Required)

Please answer each question below:

Do you have one or more of the following symptoms?(Required)
  • Fever and/or chills
  • Cough or barking cough (croup)
  • Shortness of breath
  • Sore throat
  • Difficulty swallowing
  • Decrease or loss of smell or taste
  • Pink eye
  • Runny or stuffy/congested nose
  • Headache
  • Digestive issues like nausea/vomiting, diarrhea, stomach pain
  • Muscle aches/joint pain
  • Extreme tiredness or fatigue
  • Falling down often
Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?(Required)
This can be because of an outbreak or contact tracing
In the last 10 days, have you tested positive on a rapid antigen test or a home based self-testing kit?(Required)
If you have since tested negative on a lab-based PCR test, select “No.”
In the last 14 days, have you been identified as a “close contact” of someone who currently has COVID-19?(Required)
If public health has advised you that you do not need to self-isolate (e.g., you are fully vaccinated‡ or another reason), select “No.”
In the last 14 days, have you received a COVID Alert exposure notification on your cell phone?(Required)
If you are fully vaccinated‡ or have already gone for a test and got a negative result, select "No."
In the last 14 days, have you travelled outside of Canada AND been advised to quarantine per the federal quarantine requirements?(Required)
In the last 14 days, has someone in your household (someone you live with):(Required)
  • travelled outside of Canada AND been advised to quarantine per the federal quarantine requirements; OR
  • been identified as a ”close contact” of someone who currently has COVID-19 AND advised by a doctor, healthcare provider or public health unit to self isolate?

If you are fully vaccinated, select “No.”
Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?(Required)
If you are fully vaccinated, select “No.”
Are you fully vaccinated, and it has been at least 14 days since receiving your second dose?(Required)
Note:
If the individual experiencing symptoms received a COVID-19 vaccination in the last 48 hours and is experiencing mild headache, fatigue, muscle aches, and/or joint pain that only began after vaccination, select “No.”

ONLY FULLY VACCINATED PEOPLE ARE ALLOWED TO ENTER THIS OFFICE AND MUST PROVIDE PROOF OF VACCINATION BEFORE ENTERING.
Verification of Accuracy:(Required)
I confirm that I have answered all of the above as truthfully and accurately as I can
Important Privacy Information
Any information you provide in our Covid risk screening form will be used only for the purpose of provincial contract tracing requirements, and not for marketing purposes. If the date of your visit coincides with a confirmed case of COVID-19, your contact information will be sent to public health authorities for use in contact tracing measures.

‡ Fully vaccinated is defined as an individual ≥14 days after receiving their second dose of a two-dose COVID-19 vaccine series or their first dose of a one-dose COVID-19 vaccine series.
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