COVID-19 Screening Questionnaire
⚠️ To be completed at home before attending class.
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.
2. Have you travelled outside of Canada in the past 14 days? [ ] Yes [ ] No
3. Have you had close contact with a confirmed or probable case of COVID-19? [ ] Yes [ ] No
If the individual answers NO to all questions from 1 through 3, they have passed and can enter the facility.
If the individual answers YES to any questions from 1 through 3, they have not passed and cannot enter the facility. They should go home to self-isolate immediately and contact Telehealth Ontario (1 866-797-0000) to find out if they need a COVID-19 test.
Update: Nov. 18, 2020
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 [ ] Yes [ ] No
- Difficulty breathing or shortness of breath [ ] Yes [ ] No
- Cough [ ] Yes [ ] No
- Sore throat, trouble swallowing [ ] Yes [ ] No
- Runny nose/stuffy nose or nasal congestion [ ] Yes [ ] No
- Decrease or loss of smell or taste [ ] Yes [ ] No
- Nausea, vomiting, diarrhea, abdominal pain [ ] Yes [ ] No
- Not feeling well, extreme tiredness, sore muscles [ ] Yes [ ] No
2. Have you travelled outside of Canada in the past 14 days? [ ] Yes [ ] No
3. Have you had close contact with a confirmed or probable case of COVID-19? [ ] Yes [ ] No
If the individual answers NO to all questions from 1 through 3, they have passed and can enter the facility.
If the individual answers YES to any questions from 1 through 3, they have not passed and cannot enter the facility. They should go home to self-isolate immediately and contact Telehealth Ontario (1 866-797-0000) to find out if they need a COVID-19 test.
Update: Nov. 18, 2020
