Questionnaire In the last 14 days...Please enable JavaScript in your browser to complete this form.Have you been advised to self-isolate at home? *YesNoHave you traveled outside of Canada recently? *YesNoHave you been in contact with someone who has tested positive or is suspected of having Covid-19? *YesNoDo you have a fever? Temperature greater or equal to 38 degrees *YesNoDo you have a cough? *YesNoDo you have symptoms of a cold? *YesNoDo you have new symptoms of difficulty breathing or shortness of breath? *YesNoName *FirstLastEmail *Phone *NameSubmit
