Visitor Online Screening Form

Visitor Screening

Visitor Information

Screening Questions - Section 1

Are you currently experiencing any of these symptoms? Choose any/all that are new,
worsening, and not related to other known causes or medical conditions.

Additional Screening Questions

If you already went for a test and got a negative result, select “No.”

These Instructions show if you answered “YES” to any of the symptoms included under question 1:

• Contact the school/child care to let them know about this result.
• You should isolate (stay home) and not leave except to get tested or for a medical emergency.
• Talk with a doctor/health care provider to get advice or an assessment, including if you need a COVID-19 test.
• Household members without symptoms may go to school/child care/work. Check your local public health unit’s website or call to see if they have different rules based on local risk.

These Instructions show if you answered “YES” to question 2 or 4:

• Contact the school/child care to let them know about this result.
• You should isolate (stay home) for 14 days and not leave except to get tested or for a medical emergency.
• Follow the advice of public health. You can return to school/child care only after you are cleared by your local public health unit.
• Household members without symptoms may go to school/child care/work. Check your local public health unit’s website or call to see if they have different rules based on local risk.

These Instructions show if you answered “YES” to question 3:

• Contact the school/child care to let them know about this result.
• You should isolate (stay home) for 14 days and not leave except to get tested or for a medical emergency.
• Talk with a doctor/health care provider to get advice or an assessment, including if you need a COVID-19 test. You can return to school/child care only when you are cleared by your local public health unit, regardless of test result.

These Instructions show if you answered “YES” to question 5:

• Contact the school/child care to let them know about this result.
• You should isolate (stay home) for 14 days and not leave except to get tested or for a medical emergency.
• Visit an assessment centre to get a COVID-19 test. Talk with a doctor/health care provider for more advice.
If you answered “NO” to all questions, you may go to school/child care.
By checking the box below, I hereby declare that:
The information provided is to the best of my knowledge accurate, truthful
& correct in all respects, and I have not omitted to disclose any information. *