1. Are you experiencing any of the following symptoms?
(they must not be chronic or related to another condition)

Fever, cough, shortness of breath, sore throat, difficulty swallowing, decrease or loss of smell or taste, pink eye, runny or stuff nose, headache (long lasting – not a migraine), nausea, vomiting, diarrhea, stomach pain, muscle aches, joint pain, unusual fatigue, falling down often:
YesNo

2. Has a doctor or heath care provider or public health unit told you that you should be isolating (staying at home)?
(this can be because of an outbreak or contact tracing)
YesNo

3. In last 10 days have you tested positive on a rapid antigen test or home-based self-testing kit?
(if you have tested negative on a lab-based PCR test select NO)
YesNo

4. In the last 14 days have you been identified as a “close contact” of someone who currently has COVID-19?
(if you are fully vaccinated and have not been advised to self-isolate by public, select NO)
YesNo

5. In the last 14 days have you receive a COVID Alert exposure notification on your cell phone?
(IF you are fully vaccinated and/or have already gone for a test and got a negative result, select NO)
YesNo

6. In the last 14 days, have you travelled outside of Canada and been advised to quarantine per the federal quarantine requirements?
(if you are not fully vaccinated and you live with someone who travelled outside of Canada – you can work or go out for essential reasons only)
YesNo

7. Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?
(if you are fully vaccinated select NO)
YesNo

If you have answered YES to any of these questions, please contact the office at 519-688-6342.