Pre Screening Phone First Name * Last Name * Mobile Number * Do you have any of the below symptoms: * Fever (greater than 38.0C) Cough Shortness of Breath / Difficulty Breathing Sore throat Runny Nose None of Above Have you, or anyone in your household travelled outside of Canada in the last 14 days? * Yes No Have you, or anyone in your household been in contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID19? * Yes No Are you currently being investigated as a suspect case of COVID-19? * Yes No Have you tested positive for COVID-19 within the last 10 days? * Yes No
