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COVID Screening Form
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Are you experiencing any of the following symptoms? Select all that apply.
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Note: Contact 911 if you are experiencing any symptoms requiring emergency care (e.g., severe difficulty breathing).
Have you had contact with any person with, or under investigation for, COVID-19 in the last 14 days?
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Have you or anyone from your immediate household travelled outside of Canada in the past 14 days (for non-essential travel)?
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In the past 10-14 days, have you been required to quarantine or isolate by your local public health authority?
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