COVID-19 Screen COVID-19 SCREENING QUESTIONAIREYou are required you to fill out the following questionnaire each day prior to attending any physiotherapy session to provide a safe environment.Name *Email Address *Question 1.Do you have any of the following symptoms which are new or worsened if associated with allergies, chronic or pre-existing conditions: fever >37.8°C, cough or worsening of chronic cough, new or worsening shortness of breath, new or worsening difficulty breathing, sore throat, and/or runny nose?yesnoQuestion 2.Have you had chills, painful swallowing, stuffy nose, headache, feeling unwell, fatigue or severe exhaustion, nausea, vomiting, diarrhea, or unexplained loss of appetite, loss of sense of smell or taste or conjunctivitis (pink eye) not related to a pre-existing medical condition in the last 24 hours?yesnoQuestion 3.Have you or anyone in your household who is not double vaccinated returned to Canada from outside the country (including USA) in the past 14 days?yesnoQuestion 4.Have you, or anyone in your household been in close contact* in the last 10 days with someone who has a probable** or confirmed case of COVID-19?yesno*Close contact includes providing care, living with or otherwise having close prolonged contact (within 2 meters) while the person was ill, or contact with infectious bodily fluids (e.g. from a cough or sneeze) while not wearing recommended Personal Protective Equipment (PPE). **Probable case is a person with clinical illness who had close contact to a lab-confirmed COVID-19 case, while not wearing appropriate PPE, OR a person with clinical illness who meets the COVID-19 exposure criteria, AND in whom laboratory diagnosis of COVID-19 is inconclusive.Question 5.Are you currently being investigated as a suspect case of COVID-19?yesnoQuestion 6.Have you tested positive for COVID-19 within the last 14 days?yesnoPass ResultAssessment Result: GREEN/PASS Clicking the 'Send Message' button finalizes your questionnaire. If you're reading this in an email, you're done! Please remember to wear a mask to your appointmentFailed ResultAssessment Result: RED/FAIL Clicking the 'Send Message' button finalizes your questionnaire. If you're reading this in an email, you're done! You are not permitted to attend physiotherapy at this time and you must self-isolate. Please review the Isolation Protocol for guidance pertaining to the actions to be taken upon development of symptoms, coming into close contact with a positive or presumed positive COVID-19 individual and/or obtaining a positive or presumed positive COVID-19 test yourself.Send Message