Q1: Did you travel outside of Canada in the past 14 days?

Q2: Have you tested positive for COVID-19 or had close contact with a confirmed case of COVID-19 without wearing appropriate PPE?

Q3: Do you have any of the following symptoms?

• Fever
• New onset of cough
• Worsening chronic cough
• Shortness of breath
• Difficulty breathing
• Sore throat
• Difficulty swallowing
• Decrease of loss of sense of taste or smell
• Chills
• Headaches
• Unexplained fatigue/malaise/muscle aches (myalgias)
• Nausea/vomiting, diarrhea, abdominal pain
• Pink eye (conjunctivitis)
• Runny nose or nasal congestion without other known cause

Q4: If you are 70 years of age or older, are you experiencing any of the following symptoms?

• Delirium
• Unexplained or increased number of falls
• Acute functional decline
• Worsening of chronic conditions

If response to ANY of the screening questions is YES, the appointment should be deferred and you should contact Assessment Centre, Telehealth (1-866- 787-0000), or Primary Care Provider for the assessment and testing.