COVID-19 WELLNESS SELF ASSESSMENT AGREEMENT

  • Digital Pro Inc. (DPI) is focused on the health and well-being of all personnel. As a result of the COVID-19 outbreak, we are taking precautionary measures to keep the workplace safe for everyone. Please help us maintain a safe environment by signing this Wellness Self-Assessment Agreement and agreeing to perform this wellness check each day prior to arriving on site. If you answer “yes” to any of these questions, do NOT report to any onsite work location. If you are an DPI employee, contact the Leave of Absence department at [email protected] to discuss next steps with your manager and to take time off to care for yourself or work from home.
  • Upon arrival, you may also be asked to submit to a noninvasive temperature check and/or be asked to confirm your self-assessment answers before entering our facilities. By completing this agreement, you certify you will perform this wellness self-assessment 2 hours prior to your arrival at any DPI facility and your response to each question is “no.” You also certify you will comply with all health and safety rules and procedures in effect at any applicable onsite work location.
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  • You must select the below box to receive a copy of the this form and DPI's Privacy Notice.

  • Our collection, use and disclosure of the personal information in this form is governed by a Privacy Notice that describes how we are using that personal information (primarily, to manage the physical safety of our personnel in the workplace and ensure we comply with applicable public health orders and regulations) and explains your rights with regard to that information.