For individuals 18 years of age or older
1. Do you have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions.
Choose any/all that are new, worsening, and not related to other known causes or medical conditions.
Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or
higher
Not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have
Not related to asthma or other known causes or conditions you already have
Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already have
Not related to other known causes or conditions (for example, seasonal allergies, acid reflux)
Painful swallowing, not related to other known causes or
conditions
Conjunctivitis, not related to other known causes or conditions
(for example, reoccurring styes)
Not related to other known causes or conditions (for example, seasonal allergies, being outside in cold weather)
Unusual, long-lasting (not related to tension-type headaches, chronic migraines, or other known causes or conditions you already have)
If you received a COVID-19 vaccination in the last 48 hours and are experiencing a mild headache that only began after vaccination, select “No.”
Not related to other known causes or conditions (for example, irritable bowel syndrome, menstrual cramps)
Unusual, long-lasting (not related to a sudden injury, fibromyalgia, or other known causes or conditions you already have)
If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild muscle aches/joint pain that only began after vaccination, select “No.”
Unusual tiredness, lack of energy (not related to depression, insomnia, thyroid dysfunction, or other known causes or conditions you already have)
If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild fatigue that only began after vaccination, select “No.”
For older people
For individuals under the age of 18
1. Do you have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions.
Choose any/all that are new, worsening, and not related to other known causes or medical conditions.
Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or
higher
Continuous, more than usual, making a whistling noise when breathing, not related to other known causes or conditions (for example, asthma, post-infectious reactive airways, COPD)
Out of breath, unable to breathe deeply, not related to other known causes or conditions (for example, asthma)
Not related to other known causes or conditions (for example, allergies, neurological disorders)
Painful swallowing, not related to other known causes or
conditions
Not related to other known causes or conditions (for example, seasonal allergies, being outside in cold weather)
Unusual, long-lasting (not related to tension-type headaches, chronic migraines, or other known causes or conditions you already have)
If you received a COVID-19 vaccination in the last 48 hours and are experiencing a mild headache that only began after vaccination, select “No.”
Not related to other known causes or conditions (for example, irritable bowel syndrome, menstrual cramps)
Unusual, fatigue, lack of energy (not related to depression, insomnia, thyroid dysfunction, sudden injury, or other known causes or conditions you already have)
If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild muscle aches that only began after vaccination, select “No.” If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild fatigue that only began after vaccination, select “No.”
In the last 14 days, have you travelled outside of Canada AND been advised to quarantine per the federal quarantine requirements?
If you are not fully vaccinated and you live with someone who travelled outside of Canada, see Notes below.
If the individual experiencing symptoms received a COVID-19 vaccination in the last 48 hours and is experiencing mild headache, fatigue, muscle aches, and/or joint pain that only began after vaccination, select “No.”
If you are fully vaccinated and have not been advised to self-isolate by public health, select “No”.
This can be because of an outbreak or contact tracing.
If you are fully vaccinated and/or have already gone for a test and got a negative result, select "No."
If you have since tested negative on a lab-based PCR test, select “No."
If you are fully vaccinated, select “No.”
