COVID-19 Self Screening | Breathing Room

Name *

First

Last

Do you currently have any of the following symptoms: Fever, cough, shortness of breath or difficulty breathing, sore throat, chills, painful swallowing, runny nose or nasal congestion, feeling unwell or fatigued, nausea, vomiting, diarrhea, unexplained loss of appetite, loss of taste or sense of smell, muscle or joint aches, headache, conjunctivitis? *

Have you or anyone is your households returned from travel outside of Canada in the last 14 days? *

Have you or your children attending the program had close, unprotected contact with someone who is ill with a cough and or fever? *

Have you or anyone in your household been in close, unprotected contact in the last 14 days, with someone who is being investigated or confirmed to be a case of COVID-19? *

If you have answered YES to any of the above questions, do not participate. Proceed home and use the AHS online assessment tool to determine if testing is recommended.

Name

Search