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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 5 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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