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COVID-19

Screening Tool

If you answer yes to any of the following questions, do not proceed to training. Please contact your trainer ASAP to discuss.

Name of Registrant

Email

Do you have any new onset (or worsening) of any of the following symptoms:

Fever?

Yes No

Cough?

Yes No

Shortness of breath / difficulty breathing?

Yes No

Runny Nose?

Yes No

Sore throat?

Yes No

Chills?

Yes No

Painful swallowing?

Yes No

nasal congestion?

Yes No

feeling unwell / fatigued?

Yes No

Nausea / Vomiting / Diarrhea?

Yes No

Unexplained loss of appetite?

Yes No

loss of sense of taste or smell?

Yes No

Muscle / joint aches?

Yes No

Headache?

Yes No

Conjunctivitis (pink eye)?

Yes No

Have you travelled outside of Canada in the last 14 days? (Individuals are legally required to quarantine for 14 days when entering or returning to Alberta from outside Canada unless exempted by the Alberta COVID-10 Border Testing Pilot Program)

Yes No

Have you had close contact with a confirmed case of covid-19 in the last 14 days?

Yes No