Students and children must screen for COVID-19 every day before going to school or child care. Parents/guardians can fill this out on behalf of a child.

    1. Are they currently experiencing any of these symptoms?

    YesNo

    YesNo

    YesNo

    YesNo

     

    2. Are they currently experiencing any of these symptoms?

    YesNo

    YesNo

    YesNo

    YesNo

    YesNo

     

    YesNo

     

    YesNo

     

    YesNo

     

    YesNo

    Thanks for completing the screening form! If any symptoms appear that could change your answer to any of the questions over the course of the day, please inform us immediately.

    Stop! You are a potential risk for COVID-19. Do not enter the workplace and return home to self-isolate immediately.

    Contact your healthcare provider or Telehealth Ontario at +1 866-797-0000 to determine if you require a COVID-19 test.