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A Pre Screening Checklist for Self Evaluation

Did the person have close contact with anyone with acute respiratory illness or travelled outside of Canada in the past 14 days?


Does the person have a confirmed case of COVID-19 or had close contact with a confirmed case of COVID-19?

Does the person have any of the following symptoms?

  • Fever

  • New onset of cough

  • Worsening chronic cough

  • Shortness of breath

  • Difficulty breathing

  • Sore throat

  • Difficulty swallowing

  • Decreased or lost sense of taste or smell

  • Chills

  • Headaches

  • Unexplained fatigue/malaise/muscle aches (myalgias)

  • Nausea/vomiting, diarrhea, abdominal pain

  • Pink eye (conjunctivitis)

  • Runny nose/nasal congestion without other known cause

If the person is 70 years of age or older, are they experiencing any of the following symptoms?

  • Delirium

  • Unexplained or increased number of falls

  • Acute functional decline, or

  • Worsening of chronic conditions

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