Screening Questions for People over 18 years

Required Screening Questions

1.    Are you currently experiencing one or more of the symptoms below that are new or worsening? Symptoms should not be chronic or related to other known causes or conditions.

Do you have one or more of the following symptoms?
Yes
No

  • Fever and/or chills - Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher
  • Cough or barking cough (croup) - Not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have
  • Shortness of breath - Not related to asthma or other known causes or conditions you already have
  • Sore throat - Not related to seasonal allergies, acid reflux, or other known causes or conditions you already have
  • Difficulty swallowing - Painful swallowing not related to other known causes or conditions you already have
  • Decrease or loss of    smell or taste - Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already have
  • Pink eye - Conjunctivitis (not related to reoccurring styes or other known causes or conditions you already have)
  • Runny or stuffy/congested nose - Not related to seasonal allergies, being outside in cold weather, or other known causes or conditions you already have
  • Headache - Unusual, long-lasting (not related to tension-type headaches, chronic migraines, or other known causes or conditions you already have)
    If you received a COVID-19 vaccination in the last 48 hours and are experiencing a mild headache that only began after vaccination, select “No.”
  • Digestive issues like nausea/vomiting, diarrhea, stomach pain - Not related to irritable bowel syndrome, menstrual cramps, or other known causes or conditions you already have
  • Muscle aches/joint pain - Unusual, long-lasting (not related to a sudden injury, fibromyalgia, or other known causes or conditions you already have)
    If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild fatigue that only began after vaccination, select “No.”
  • Fatigue - Unusual tiredness, lack of energy (not related to depression, insomnia, thyroid dysfunction, or other known causes or conditions you already have)
    If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild fatigue that only began after vaccination, select “No.”
  • Falling down often - For older people

2.    Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?
This can be because of an outbreak or contact tracing.
Yes
No

3.    In the last 14 days, have you been identified as a “close contact” of someone who currently has COVID-19?
If public health has advised you that you do not need to self-isolate (e.g., you are fully vaccinated* or another reason), select “No.”
Yes
No

4.    In the last 14 days, have you traveled outside of Canada AND been advised to  quarantine per the federal quarantine requirements?
Yes
No

5.    Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?
If you are fully vaccinated, select “No.”
Yes
No
If the individual experiencing symptoms received a COVID-19 vaccination in the last 48 hours and is experiencing mild headache, fatigue, muscle aches, and/or joint pain that only began after vaccination, select “No.”

Fully vaccinated is defined as an individual ≥14 days after receiving their second dose of a two-dose COVID-19 vaccine series or their first dose of a one-dose COVID-19 vaccine series.