1. Do you have a fever or have felt hot or feverish anytime in the last two weeks? *
2. Do you have any of these symptoms: Dry cough? Shortness of breath? Difficulty breathing? Sore throat? Runny nose? Sneezing? Post-nasal drip? *
3. Have you experienced a recent loss of smell or taste? *
4. Have you been in contact with any confirmed COVID-19 positive patients, or persons self-isolating because of a determined risk for COVID-19? *
5. Are you over the age of 80? *
6. Do you have any of the following? Heart disease, lung disease, kidney disease, diabetes or any auto-immune disorder? *
7. Have you returned from travel outside of Canada in the last 14 days? *
8. Have you returned from travel within Canada from a location known affected with COVID-19? * *