COVID PreScreening Questions

COVID Pre-Appointment Screening Questions

Full Name

Has doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?
Have you been been identified as a "close contact" of someone who currently has COVID-19 in the last 14 days?
Have you have received a COVID Alert exposure notification on your cell phone in the last 14 days (and have not been tested or waiting for your results)?
Have you or anyone you live with traveled outside of Canada in the last 14 days?
Do you live with anyone currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?

I confirm that that the answer to all the above questions is NO. (If you answer yes to any of the above questions, please do not come to your appointment. Call our clinic to reschedule.

Do you have any one or more COVID-19 symptoms below:

fever (>38 deg) or chills
cough or barking cough (croup)
shortness of breath
sore throat
difficulty swallowing
decrease or loss of smell or taste
runny or stuffy / congested nose
headache
nausea / vomiting, diarrhea
muscle aches
extreme tiredness
pink eye
stomach pain

I have one or more the symptoms above.

I confirm that I DO NOT have any of the symptoms above.

Do NOT come to your appointment. Please call us at 705-741-1191 to speak to one of our staff. We may need to change your appointment. You can call the PRHC COVID-19 Assessment Centre at 705-876-5086 for test information.