COVID-19 Health Screening Declaration

Prescreening Form

To be completed by visitors and contractors to Lordco Auto Parts offices or locations.

In the past 14 days, have you our has anyone in your household

Please confirm the following:

By completing this form, you are consenting to the collection of personal information by Lordco Auto Parts. This information is being collected to ensure the health and safety of our employees and to comply with the recommendations of the Provincial Health Officer (PHO) to protect against the spread of COVID-19. This information will be collected and kept secure by Human Resources and will not be disclosed to any third party without your consent other than to the PHO upon request or as otherwise authorized pursuant to BC’s Personal Information Protection Act.