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.
Do you have any of the following new or worsening symptoms?  
  • Fever or chills
  • Cough 
  • Trouble breathing
  • Nausea, Vomiting or diarrhea
  • Decrease or loss of taste or smell
  • Very tired, sore muscles/joints
Note: You may answer NO if 
  • you were vaccinated within the previous 48 hours and began experiencing the following symptom(s) only after vaccination (headache, muscle aches/joint pain, fatigue).
  • you live with someone experiencing COVID-19 symptoms or waiting for test results after experiencing symptoms, so long as you are fully-vaccinated and have not been advised to self-isolate by public health.
  • you live with someone experiencing mild headache, fatigue, muscle aches, and/or joint pain, so long as symptoms began after vaccination (regardless of your vaccination status).
  • If mild tiredness, sore muscles or joints occur within 48 hours after getting a COVID-19 vaccine, select “No” and continue to follow all public health measures


If symptoms last longer than 48 hours or worsen, select “Yes”.
If you are sick or have any symptoms of illness, including those not listed above, stay home and seek assessment.

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4. Does anyone in your household have one or more of the symptoms above and/or are waiting for test results due to the symptoms?

NOTE:
• If you are fully vaccinated** or have tested positive for COVID-19 in the last 90 days and since been cleared,
select “No.”
• If the household member’s mild tiredness, sore muscles or joints occurred within 48 hours after getting a
COVID-19 vaccine, select “No”. If their symptoms last longer than 48 hours, select “Yes.”

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5. In the last 10 days have you been notified as a close contact of someone with COVID-19 or been told to stay home and self-isolate?

NOTE:
• If you are fully vaccinated**, have tested positive for COVID-19 in the last 90 days and since been cleared, or
if public health has told you that you do not need to self-isolate, select “No.”

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6. In the last 14 days, have you travelled outside of Canada AND been advised to quarantine per the federal quarantine requirements?

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7. In the last 10 days, have you tested positive on a rapid antigen test or a home-based self-testing kit?

NOTE:
• If you have since tested negative on a lab-based PCR test, select “No.”

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8. 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, Marie in volunteer engagement if you are a volunteer, or the person you are due to meet with if you are a guest.

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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