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.

    Check "No" to All

    Check

    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.
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo
    YesNo

    Thanks for completing the screening form! If any symptoms appear that could change your answer to any of the questions over the course of the day, please inform us immediately.

    Stop! You are a potential risk for COVID-19. Do not enter the workplace and return home to self-isolate immediately.

    Contact your healthcare provider or Telehealth Ontario at +1 866-797-0000 to determine if you require a COVID-19 test.