Wellness check questionnaire
Wellness station (Employee-facing) ON
Do not enter this site if you answer YES to any of the following questions:
- Have you travelled outside Canada in the last 14 days and are currently required to self-isolate?
- Note to donors: If you have travelled outside of Canada in the past 14 days you will not be eligible to donate even if you are not required to self-isolate.
- 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.
- Fever, chills
- difficulty breathing or shortness of breath, cough, croup (barking cough)
- decrease or loss of smell or taste
- not feeling well, extreme tiredness, sore muscles
- Have you been:
- notified by a doctor, health care provider, or public health unit that you should currently be isolating (staying at home)?
- identified in the last 14 days as a “close contact” of someone who currently has COVID-19 and notified by public health that you should currently be isolating?
- notified in the last 14 days by the COVID Alert App that you may have been exposed to COVID-19 and are currently required to self-isolate?
- In the last 10 days, have you tested positive on a rapid antigen test or a homebased self-testing kit and have not received a negative result on a lab-based PCR test since?
- Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms and you are currently required to self-isolate?
Wellness station (Employee-facing) BC-SASK
Do not enter this site if you answer YES to any of the following questions:
- Have you travelled outside Canada in the last 14 days and are currently required to self-isolate?
- Note to donors: If you have travelled outside of Canada in the past 14 days you will not be eligible to donate even if you are not required to self-isolate.
- 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.
- Fever, chills
- difficulty breathing or shortness of breath, cough, croup (barking cough)
- decrease or loss of smell or taste
- not feeling well, extreme tiredness, sore muscles
- Have you been:
- notified by a doctor, health care provider, or public health unit that you should currently be isolating (staying at home)?
- identified in the last 14 days as a “close contact” of someone who currently has COVID-19 and notified by public health that you should currently be isolating?
- notified in the last 14 days by the COVID Alert App that you may have been exposed to COVID-19 and are currently required to self-isolate?
- In the last 10 days, have you tested positive on a rapid antigen test or a homebased self-testing kit and have not received a negative result on a lab-based PCR test since?
- Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms and you are currently required to self-isolate?
Wellness station (Employee-facing) AB
Do not enter this site if you answer YES to any of the following questions:
- Have you travelled outside Canada in the last 14 days and are currently required to self-isolate?
- Note to donors: If you have travelled outside of Canada in the past 14 days you will not be eligible to donate even if you are not required to self-isolate.
- 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.
- Fever, chills
- difficulty breathing or shortness of breath, cough, croup (barking cough)
- decrease or loss of smell or taste
- not feeling well, extreme tiredness, sore muscles
- Have you been :
- notified by a doctor, health care provider, or public health unit that you should currently be isolating (staying at home)?
- identified in the last 14 days as a “close contact” of someone who currently has COVID-19?
- notified in the last 14 days by the COVID Alert App that you may have been exposed to COVID-19 and are currently required to self-isolate?
- In the last 10 days, have you tested positive on a rapid antigen test or a homebased self-testing kit and have not received a negative result on a lab-based PCR test since?
- Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms and you are currently required to self-isolate?
Wellness station (Employee-facing) NS
Do not enter this site if you answer YES to any of the following questions:
- Have you travelled outside Nova Scotia in the last 14 days and are currently required to self-isolate?
- Note to donors: If you have travelled outside of Canada in the past 14 days you will not be eligible to donate even if you are not required to self-isolate.
- 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.
- Fever, chills
- difficulty breathing or shortness of breath, cough, croup (barking cough)
- decrease or loss of smell or taste
- not feeling well, extreme tiredness, sore muscles
- Have you been:
- notified by a doctor, health care provider, or public health unit that you should currently be isolating (staying at home)?
- identified in the last 14 days as a “close contact” of someone who currently has COVID-19 and notified by public health that you should currently be isolating?
- notified in the last 14 days by the COVID Alert App that you may have been exposed to COVID-19 and are currently required to self-isolate?
- In the last 10 days, have you tested positive on a rapid antigen test or a homebased self-testing kit and have not received a negative result on a lab-based PCR test since?
- Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms and you are currently required to self-isolate?