COVID-19 Survey

COVID-19 Survey

Required Screening Questions

1. Do you have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions.
Fever or chills *
Difficulty breathing or shortness of breath *
Cough *
Sore throat, trouble swallowing *
Runny nose/stuffy nose or nasal congestion *
Decrease or loss of smell or taste *
Nausea, vomiting, diarrhea, abdominal pain *
Not feeling well, extreme tiredness, sore muscles *


2. Have you travelled outside of Canada in the past 14 days? *

Close Contact

3. Have you had any close contact with a confirmed or probable case of COVID-19? *