COVD-19 Self-assessment

COVID-19 Self-Assessment
Are you currently experiencing any of these issues? Call 911 if you are. Severe difficulty breathing (struggling for each breath, can only speak in single words) Severe chest pain (constant tightness or crushing sensation) Feeling confused or unsure of where you are Losing consciousness *
How old are you? We collect this anonymous information to better understand how the virus affects different age groups. *
Are you currently experiencing any of these symptoms? Choose any/all that are new and not related to seasonal allergies or pre-existing medical conditions. *
Are you in any of these at-risk groups? Getting treatment that compromises (weakens) your immune system (for example, chemotherapy, medication for transplants, corticosteroids, TNF inhibitors) Having a condition that compromises (weakens) your immune system (for example, lupus, rheumatoid arthritis, immunodeficiency disorder) Having a chronic (long-lasting) health condition (for example, diabetes, emphysema, asthma, heart condition, COPD) Regularly going to a hospital or health care setting for a treatment (for example, dialysis, surgery, cancer treatment) *
In the last 14 days, have you been in close physical contact with someone who tested positive for COVID-19? Close physical contact means: being less than 2 metres away in the same room, workspace, or area living in the same home *
In the last 14 days, have you been in close physical contact with someone who either: • is currently sick with new COVID-19 symptoms (like a cough, fever, or difficulty breathing)? or • returned from outside of Canada in the last 2 weeks with new COVID-19 symptoms (like a cough, fever, or difficulty breathing)? Close physical contact means: being less than 2 metres away in the same room, workspace, or area living in the same home *
Have you travelled outside of Canada in the last 14 days? This does not include essential workers who cross the Canada-US border regularly. *