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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.

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* 1. Contact Information

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* 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.

  Yes No
Fever or chills
Difficulty breathing or shortness of breath
Sore throat, trouble swallowing
Decrease or loss of taste or smell
Muscle aches and pains
Extreme tiredness, lack of energy or feeling unwell
Runny or stuffy/congested nose

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

0 of 10 answered