COVID-19 Screening Questionaire

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?

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

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