Covid-19 Health Declaration

How are you feeling today?

1. Fever and/or chills Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher
Difficulty swallowing Painful swallowing, not related to other known causes or conditions
Cough or barking cough (croup) Continuous, more than usual, making a whistling noise when breathing, not related to other known causes or conditions (for example, asthma, post-infectious reactive airways, COPD)
Pink eye Conjunctivitis, not related to other known causes or conditions (for example, reoccurring styes)
Runny or stuffy/congested nose Not related to other known causes or conditions (for example, seasonal allergies, being outside in cold weather)
Shortness of breath Out of breath, unable to breathe deeply, not related to other known causes or conditions (for example, asthma)
Decrease or loss of smell or taste Not related to other known causes or conditions (for example, allergies, neurological disorders)
Headache that’s unusual or long lasting Not related to other known causes or conditions (for example, tension-type headaches, chronic migraines)
Sore throat Not related to other known causes or conditions (for example, seasonal allergies, acid reflux)
Digestive issues like nausea/vomiting, diarrhea, stomach pain Not related to other known causes or conditions (for example, irritable bowel syndrome, menstrual cramps)
Muscle aches that are unusual or long lasting Not related to other known causes or conditions (for example, a sudden injury, fibromyalgia)
Extreme tiredness that is unusual Fatigue, lack of energy, not related to other known causes or conditions (for example, depression, insomnia, thyroid dysfunction)
Falling down often For older people
2. Have you travelled outside of Canada in the last 14 days?If you are an essential worker who crosses the Canada-US border regularly for work, select “No”.
3. In the last 14 days, has a public health unit identified you as a close contact ofsomeone who currently has COVID-19?
4. Has a doctor, health care provider, or public health unit told you that you shouldcurrently be isolating (staying at home)?
5. In the last 14 days, have you received a COVID Alert exposure notification on yourcell?If you already went for a test and got a negative result, select “No.”

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