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COVID Screening Form
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Do you have a fever?
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Do you have any of the following signs or symptoms?
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New onset of cough
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Difficulty breathing
New loss or decrease in sense of taste or smell
Runny nose
Sneezing (not allergy related)
Hoarse voice
Nasal congestion
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Difficulty swallowing
Headache
Unexplained fatigue or malaise
Nausea/vomiting, diarrhea, abdominal pain
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Have you been in contact with anyone with COVID-19, acute respiratory illness, or travelled outside of Canada in the past 14 days?
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Did you wear the required PPE according to the type of duties you were performing when you had close contact with a suspected or confirmed case of COVID-19?
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