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AreaX.O Visitor COVID Screening

Please ensure you fill out this form prior to or when you visit the Invest Ottawa Area X.O Test Facility.
Please note only fully vaccinated individuals are permitted to enter the site at this time.
We appreciate your cooperation.

*1.Contact Information(Required.)

Full Name

Company Name

Email Address

Phone Number

*2.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.(Required.)

Yes

No

Fever or chills

Yes

No

Difficulty breathing or shortness of breath

Yes

No

Cough

Yes

No

Sore throat, trouble swallowing

Yes

No

Decrease or loss of taste or smell

Yes

No

Muscle aches and pains

Yes

No

Extreme tiredness, lack of energy or feeling unwell

Yes

No

Runny or stuffy/congested nose

Yes

No

*3.Did you answer "yes" to any of the above symptoms?(Required.)

Yes

No

Current Progress,

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