Covid Self-Assessment Form

Do you have any of the following symptoms? If YES to any of the symptoms, please do not enter the facility and contact staff directly 1-800-716-7310.(required)

Have you or someone you have been in contact with tested positive for COVID-19 in the past 14 days? If YES, please do not enter the facility and contact staff directly 1-800-716-7310.(required)

Have you travelled outside of Canada in the past 14 days? If YES, please do not enter the facility and contact staff directly 1-800-716-7310.(required)

Did you receive your final (or second) vaccination dose more than 14 days ago? *Answer will be required after September 22, 2021. If NO, please do not enter the facility and contact staff directly 1-800-716-7310.(required)