Artc customer screening

Do you or any of your family members have any of the following symptoms?

New or worsening cough

Yes                                 No

Shortness of breath

Yes                                 No

Sore throat 

Yes                                 No

Runny nose, sneezing or nasal congestion 

Yes                                 No

Hoarse voice 

Yes                                 No

Difficulty swallowing 

Yes                                 No

New smell or taste disorder(s) 

Yes                                 No

Nausea/vomiting, diarrhea, abdominal pain 

Yes                                 No

Unexpected fatigue/malaise 

Yes                                 No

Headache 

Yes                                 No

Have you or any of your family members traveled outside of Canada and/or had close contact with anyone that has travelled outside of Canada in the past 14 days?

Yes                                 No

Do you or any of your family members have a fever?

Yes                                 No

Have you or any of your household had close contact with anyone with respiratory illness or a confirmed/probable case of COVID-19?

Yes                                 No

If you answered Yes to the previous question When you had close contact with a suspected or confirmed case of COVID-19, did you wear the required and/or recommended PPE according to the type of contact (e.g. goggles, gloves, mask, gown, or N95?

Yes                                 No

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