top of page
Covid-19 Screening Form
Are you experiencing any of the following symptoms with unknown cause: fever, cough, shortness of breath, muscle pain, loss of taste or loss of smell?
Have you had close contact with any person IN SELF ISOLATION, QUARANTINE or under investigation for COVID-19 in the past 14 days?
Have you been in close contact with anyone who has been traveling internationally recently?
Have you had contact in the last 14 days with a person being tested with Covid-19?

Thanks for submitting!

bottom of page