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COVID-19 Screening Questions

COVID-19 DECLARATION

  1. Do you have any of the below symptoms:
    • Fever (greater than 38.0°C) YES NO
    • Cough YES NO
    • Shortness of Breath / Difficulty Breathing YES NO
    • Sore throat YES NO
    • Runny Nose YES NO
  2. Have you, or anyone in your household traveled outside of Canada in the last 14 days? YES NO
  3. Have you, or anyone in your household been in contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19? YES NO
  4. Are you currently being investigated as a suspect case of COVID-19? YES NO
  5. Have you tested positive for COVID-19 within the last 10 days? YES NO

IF YOU ANSWER YES TO ANY OF THE ABOVE QUESTIONS, YOU WILL BE ASKED TO RETURN HOME & CONTACT AHS FOR TESTING &MANAGEMENT OF SUSPECTED COVID-19

IF YOU ANSWER NO TO ALL OF THE ABOVE QUESTIONS, YOU WILL BE ESCORTED TO THE CLINIC FOR YOUR APPOINTMENT

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