Covid 19 Screening Questions

To help us prevent the spread of Covid 19, we ask you to read this carefully and answer the questions below.

Covid 19 Screening Questions

Name(Required)

First Last

Email(Required)

Has anyone in your household experienced any symptoms in the past 14 days?(Required)

Yes

Have you experienced any Covid 19 symptoms?(Required)

Yes

Have you been in contact with anyone who is suspected or confirmed to have Covid 19?(Required)

Yes

Have you travelled outside of Canada within the last 14 days or been in contact with someone who has travelled outside Canada in the past 14 days?(Required)

Yes