COVID 19 SELF-SCREENING ATTESTATION
PLEASE ANSWER THE FOLLOWING QUESTIONS
1. Do you have a cough, fever, sore throat, difficulty breathing or any other new or worsening symptoms?
2. Have you travelled outside of Canada in the past 14 days?
3. Have you had close contact with a person with acute respiratory illness who has travelled anywhere outside of Canada within the last 14 days before their illness?
4. Have you been in close contact with a confirmed or probable case of COVID-19 in the past 14 days?
If you answer
to any of the above questions, or are in doubt, contact your health care provider for advice.
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up-to-date COVID-19 information.