• This screening tool is based on the latest COVID-19 case definitions and the Coronavirus disease (COVID-2019) situation reports published by the World Health Organization.
  • 1) Have you traveled outside of Canada in the past 14 days?
  • 2) Have you tested positive for COVID-19 or had close contact with a confirmed case of COVID-19 without wearing appropriate PPE?
  • 3) Do you have any of the following symptoms? • Fever • New onset of cough • Worsening chronic cough • Shortness of breath • Difficulty breathing • Sore throat • Difficulty swallowing • Decrease of loss of sense of taste or smell • Chills • Headaches • Unexplained fatigue/malaise/muscle aches (myalgias) • Nausea/vomiting, diarrhea, abdominal pain • Pink eye (conjunctivitis) • Runny nose or nasal congestion without other known cause
  • 4) Are you 70 years of age or older, and experiencing any of the following symptoms? • Delirium • Unexplained or increased number of falls • Acute functional decline • Worsening of chronic conditions
  • MM slash DD slash YYYY