COVID SCREENING CHECKLIST CHORISTERS SING-IT
Please do not enter the building if you answer YES to any of these questions. Symptoms should not be chronic or related to other known causes or conditions. Are you currently experiencing any one of the symptoms below that are new or worsening?
Do you have any of the following symptoms?
Fever and/or chills
Temperature of 37.8 degrees Celsius
Cough or barking cough (croup)
Not related to asthma, post infectious reactive airways, COPD, or other known causes or conditions you already have
Shortness of breath
Not related to asthma or other known causes or conditions you already have
Sore throat
Not related to seasonal allergies, acid reflux, or other known causes or conditions you already have
Difficulty swallowing
Painful swallowing not related to other known causes…etc.
Decrease or loss of smell or taste
Not related to seasonal allergies, neurological disorders or other known prior conditions
Pink eye
Conjunctivitis not related to reoccurring styes or other known causes or conditions
Runny or stuffy/congested nose
Not related to seasonal allergies, being in cold weather, or other existing conditions
Headache
Unusual, long-lasting not related to tension-type headaches, chronic migraines, or other known conditions or causes existing
Digestive issues like nausea/vomiting, diarrhea, stomach pains
Not related to any other known causes or conditions like irritable bowel syndrome
Muscle aches
Unusual, long-lasting, not related to a sudden injury, fibromyalgia, or other known causes
Extreme tiredness
Unusual fatigue, lack of energy (not related to depression, insomnia, thyroid dysfunction or other known causes)
All answers for the following questions should be NO. If yes, please wait until you can answer NO to these questions.
Do you have any of the following symptoms?
Fever and/or chills
Temperature of 37.8 degrees Celsius
Cough or barking cough (croup)
Not related to asthma, post infectious reactive airways, COPD, or other known causes or conditions you already have
Shortness of breath
Not related to asthma or other known causes or conditions you already have
Sore throat
Not related to seasonal allergies, acid reflux, or other known causes or conditions you already have
Difficulty swallowing
Painful swallowing not related to other known causes…etc.
Decrease or loss of smell or taste
Not related to seasonal allergies, neurological disorders or other known prior conditions
Pink eye
Conjunctivitis not related to reoccurring styes or other known causes or conditions
Runny or stuffy/congested nose
Not related to seasonal allergies, being in cold weather, or other existing conditions
Headache
Unusual, long-lasting not related to tension-type headaches, chronic migraines, or other known conditions or causes existing
Digestive issues like nausea/vomiting, diarrhea, stomach pains
Not related to any other known causes or conditions like irritable bowel syndrome
Muscle aches
Unusual, long-lasting, not related to a sudden injury, fibromyalgia, or other known causes
Extreme tiredness
Unusual fatigue, lack of energy (not related to depression, insomnia, thyroid dysfunction or other known causes)
All answers for the following questions should be NO. If yes, please wait until you can answer NO to these questions.
- Has a doctor, healthcare provider, or public health unit told you that you should currently be isolating (staying at home?)
- In the last 14 days, have you been identified as a “close contact” with some who currently has COVID-19?
- In the last 14 days, have you received a COVID alert exposure notification on your cellphone? (If you already went for a test and got a negative result, select no)
- In the last 14 days, have you travelled outside of Canada?