St. Catharines SDA Self-Screen

Self-Screen for COVID-19

This screening tool must be completed by all visitors who intend to enter a St. Catharines SDA Church. Visitors are not permitted inside the building before completing this self-screen.

The health of our visitors depends on our honesty and accuracy in completing this screening tool.

Thank you for your understanding and your commitment to the health of one another.

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* 1. Please enter your name.

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* 2. Have you been outside of Canada in the past 14 days?

Yes

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* 3. Has someone you are in close contact with tested positive for COVID-19?

Yes

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* 4. Do you live with someone who was tested for COVID-19 due to symptoms or close contact with someone who tested positive, and/or is awaiting their results?

Yes

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* 5. Do you have any of the following symptoms?

Fever / chills

Cough (new or worse)

Shortness of breath (even when sitting or walking regularly)

Sore throat

Runny nose/nasal congestion (not due to allergies)

Unusual level of fatigue

Unusual headache

Nausea / vomiting, diarrhea, or loss of appetite

Feeling unwell for an unknown reason

Yes