Please read and respond to the questions below.
Fill out your information and press the Get Tag button at the bottom of the
page to generate
In the past 10 days have you experienced any of the following symptoms?
• Fever and/or chills
• Cough or barking cough (croup)
• Shortness of breath
• Decrease or loss of sense of taste or smell
• Sore throat
• Runny or stuffy/congested nose
• Muscle aches or joint pain
• Nausea, vomiting and/or diarrhea
Do any of these apply to you?
• You live with someone who currently has Covid-19 symptoms
• You live with someone who is isolating because of a positive Covid-19 test result
• You live with someone who is waiting on Covid-19 test results?
• In the last 14 days someone you live with has returned from travelling outside of CANADA and is
isolating while waiting results of a Covid-19 test?