IMPORTANT:THIS MUST BE COMPLETED ON THE SAME DAY AS YOUR ARRIVAL

Name *

First

Last

Grade *

Pre School
JK
SK
1
2
3
4
5
6
7
8
9
Faculty
Administration
Management

Are you currently experiencing any of these issues? Call 911 if you are.

Severe difficulty breathing
Severe chest pain
Feeling confused or unsure of where you are
Losing consciousness

Issues *

COVID-19 self-assessment result Call 911 or go directly to your nearest emergency department.

Are you currently experiencing any of these symptoms and not related to seasonal allergies or pre-existing medical conditions?

Fever
Chills
Cough that's new or worsening
Barking cough, making a whistling noise when breathing
Shortness of breath
Sore throat
Difficulty swallowing
Runny nose
Stuffy or congested nose
Lost sense of taste or smell
Pink eye
Headache that’s unusual or long lasting
Digestive issues like nausea/vomiting, diarrhea, stomach pain
Muscle aches that are unusual or long lasting
Extreme tiredness that is unusual
Falling down often
For young children and infants: sluggishness or lack of appetite

Symptoms *

Based on your answers, we recommend that you go to a COVID-19 assessment centre to get tested as soon as you can because you have some symptoms.

In the last 14 days, have you been in close physical contact with someone who tested positive for COVID-19?

Close physical contact means:

being less than 2 metres away in the same room, workspace, or area
living in the same home

In the last 14 days, have you been in close physical contact with someone who either:

is currently sick with new COVID-19 symptoms (like a cough, fever, or difficulty breathing)?
returned from outside of Canada in the last 2 weeks with new COVID-19 symptoms (like a cough, fever, or difficulty breathing)?

14 Days *

Based on your answers, we recommend that you go to a COVID-19 assessment centre to get tested as soon as you can because you have some symptoms.

Have you travelled outside of Canada in the last 14 days?

Travel *
NO
YES

Based on your answers, you do not seem to have symptoms or be part of an at-risk group. We recommend that you be cautious when outside and keep a distance from others as much as possible.