Covid Screening Questionnaire

Please fill out the following form to help us understand your physical condition.

Do you have any of the following new or worsening symptions? Symptons that aren't cronic or related to other known contions. FEVER, SHORTNESS OF BREATH, COUGH, SORE THROAT, LOSS OF SMELL/TASTE, NAUSEA OR DIARRHEA, EXTREME FATIQUE, SORE MUSCLES.
Have you travelled outside of Canada in the last 14 days
Have you come into contact with a confirmed or probable case of COVID-19?

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