COVID-19 Daily Screening Questionnaire (18+)

Participants must screen for COVID-19 before every class.

Screening Questions (answer YES or NO to all questions)

1. In the last 5 days, have you experienced any of these symptoms?

• Fever and/or chills   Temperature of 37.8°C/100°F or higher
• Cough or barking cough (croup)   Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have)
• Shortness of breath   Out of breath, unable to breathe deeply (not related to asthma or other known causes or conditions you already have)
• Decrease or loss of smell or taste  Not related to other known causes or conditions (for example, allergies, neurological disorders)
• Sore throat or difficulty swallowing   Painful swallowing, not related to other known causes or conditions (for example, seasonal allergies, acid reflux)
• Runny or stuffy/congested nose   Not related to other known causes or conditions (for example, seasonal allergies, being outside in cold weather)
• Pink eye   Conjunctivitis (not related to reoccurring styes or other known causes or conditions you already have)
• Headache that’s unusual or long lasting   Not related to other known causes or conditions (for example, tension-type headaches, chronic migraines)
• Digestive issues like nausea/vomiting, diarrhea, stomach pain   Not related to other known causes or conditions (for example irritable bowel syndrome, menstrual cramps)
• Extreme tiredness or muscle aches that are unusual or long-lasting   Fatigue, lack of energy, not related to other known causes or conditions (for example, depression, insomnia, thyroid dysfunction, fibromyalgia, sudden injury)

Choose YES if any are new, worsening, and not related to other known causes or medical conditions. 
 YES   NO

2. In the last 14 days, have you travelled outside of Canada AND been advised to quarantine (as per the federal quarantine requirements)?
 YES   NO

3. In the last 5 days, have you tested positive for COVID-19?  If you have already completed your isolation period of 5 days because your symptoms started before your positive test result AND your symptoms have been improving for 24 hours (48 for nausea, vomiting, and/or diarrhea) AND you do not have a fever, Select “No”. 
 YES   NO

4. Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?
 YES   NO

5. Do you live with someone who is currently isolating because of a positive COVID-19 test, COVID-19 symptoms or waiting for COVID-19 test results? If you have received your booster, or completed your isolation after testing positive in the last 90 days, or if your household member is isolating because of COVID-19 symptoms but has already tested negative on one PCR or rapid molecular test, or two rapid antigen tests, select “No”.  
 YES   NO

If an individual answers YES to any of the questions, they are not allowed to attend or participate. You should isolate (stay home) and not leave except to get tested or for a medical emergency.  Talk with a doctor/health care provider or call Telehealth Ontario (1-866-797-0000) to get advice or an assessment, including if you need a COVID-19 test.