Pre-visit Questionnaire

Do you have visitor/contractor protocols in regards to COVID-19?

No Yes

A phone consultation will be set-up between you and an Alliance Staff member shortly, to help facilitate a site visit.

Please visit the Alliance website for free helpful resources and templates for your Communicable Disease Safety Plan

Please provide a copy of one of the following:

Is the meeting room large enough to maintain physical distancing (2m) between all attendees?

No Yes

A site visit may not be possible at this time. Please contact the Alliance at 604-795.9595.

Will the Alliance staff member be required to enter your facility beyond the office areas?

No Yes

Does your workplace have any of the following?

a) Toxic Process Gases

b) Mobile Equipment

c) Hot-Work Processes

d) Radiation Sources

e) High Noise Levels

Does your worksite carry out any of the following?

What PPE does the advisor need to wear while on your worksite?

Who will be the primary contact for the site visit?

Name

Phone number

Additional Comments