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This survey must be completed by all and any Arthritis Society staff, volunteers and visitors either the morning of or just before entering our premises. It cannot be completed the night before.

This survey must be completed whether you are fully vaccinated, partially vaccinated or not vaccinated (whereby vaccinated refers exclusively to vaccines currently accepted in Canada).
 
When you are on Arthritis Society premises, a reminder you must:
  • Bring and wear a mask or face covering (which covers your nose, mouth and chin)
  • Sanitize your hands upon entering the premises
  • Maintain a constant physical distance of 6 feet from others
 
If you have an existing health condition that gives you the symptoms, select “No”. If the symptom is new, different or getting worse, select “Yes”.

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1. Please enter your full name and contact telephone number.

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2. Location of Arthritis Society office that you are visiting (i.e. Toronto, London, etc.)

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3. Part A:

Do you or anyone in your household have 1 or more of the following new or worsening symptoms today or in the last 5-10 days*?  
  • Fever above 37.8 and/or chills
  • Cough 
  • Difficulty breathing
  • Decrease or loss of taste or smell
Part B:
Do you or anyone in your household have 2 or more of the following new or worsening symptoms today or in the last 5-10 days*?  
  • Sore throat
  • Headache
  • Feeling very tired
  • Runny nose / nasal congestion
  • Muscle aches / joint pain
  • Nausea, vomiting or diarrhea
Note: 
-If the symptom is from a known health condition that gives you/them the symptom, select “No”. If the symptom is new, different or getting worse, select “Yes”.
-If there is mild tiredness, sore muscles or joints within 48 hours after a COVID-19 vaccine, select “No”.
-Anyone who is sick or has any symptoms of illness, should stay home and seek assessment from their health care provider if needed.
-If you answer "Yes", stay home and self-isolate. And, your household must self-isolate**. 
- If you have 1 symptom from part B, please stay home until symptoms improve for at least 24 hours or 48 hours if nausea/vomiting/diarrhea.
*Use 5 days if fully vaccinated or 11 years or younger. Use 10 days if 12 years or older and not fully vaccinated OR immune compromised OR at a high risk congregate setting. 
**You or household members do not need to self-isolate if no symptoms and not had a positive test and either had a confirmed COVID-19 infection within 90 days OR are 18-plus and boosted OR are 17 years or younger and fully vaccinated.

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4. Have you or anyone in the household had a positive COVID-19 test in the last 5 or 10 days*, or been told to stay home and self-isolate?

Note:
-If you had a positive test or live with someone who is isolating or awaiting test results select “Yes”.
-If "Yes", stay at home and isolate**.
*Use 5 days if fully vaccinated or 11 years or younger. Use 10 days if 12 years or older and not fully vaccinated OR immune compromised OR at a high risk congregate setting. 
**You or household members do not need to self-isolate if no symptoms and not had a positive test and either had a confirmed COVID-19 infection within 90 days OR are 18-plus and boosted OR are 17 years or younger and fully vaccinated.

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5. In the last 14 days, have you travelled outside of Canada?

If “Yes”: Follow federal quarantine travel rules including required measures for quarantine exempt travelers. 
If you are not required to quarantine select "No". 

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6. If you answered "Yes" to any of these questions, go home & self-isolate right away. You are not permitted to enter Arthritis Society premises.

Please advise Sarah in HR if you are a staff member or your contact at the Arthritis Society if you are a volunteer or visitor. 

But first, call Public Health or your health care provider to seek health guidance and find out if you need a test.

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