COVID-19 Screening Assessment

Required Screening Questions:

1. Do any of the following apply to you?

  • I am fully vaccinated against COVID-19 (it has been 14 days or more since your final dose of either two-dose vaccine series)
  • I have tested positive for COVID-19 in the last 90 days (and since been cleared by the local public health unit)

If "Yes", skip questions 6, 7, and 8.

Personal health information is not collected when you complete this screening tool. The purpose of this question is to provide accurate isolation instructions, which are based on vaccination status.

2. Are you currently experiencing one or more symptoms below that are new or worsening? Symptoms should not be chronic or related to other known causes or conditions.

Fever and/or chills
Cough or barking cough (croup)
Difficulty breathing or shortness of breath
Decrease or loss of smell or taste
Fatigue, lethargy, malaise and/or muscle aches/joint pain

If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild fatigue that only began after vaccination, then select "No".

3. In the last 14 days, have you travelled outside of Canada AND been advised to quarantine (as per the federal quarantine requirements)?

4. Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?

5. In the last 10 days, have you tested positive on a rapid antigen test or a home-based self-testing kit? If you have since tested negative on a lab-based PCR test, select "No".

6. In the last 10 days, have you been identified as a "close contact" of someone who currently has COVID-19? If public health has advised you that you do not need to self-isolate, select "No".

7. In the last 14 days, have you received a COVID Alert exposure notification on your mobile phone? If you have since tested negative on a lab-based PCR test, select "No".

8. Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms? If the individual experiencing symptoms received a COVID-19 vaccination in the last 48 hours and is experiencing mild fatigue, muscle aches, and/or joint pain that only began after vaccination, select "No".

9. Please provide your full name: