Wellness check questionnaire

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We have implemented the wellness checkpoint screening process at sites nationally to now include screening of all employees, contractors, donors, visitors and volunteers. This process is in place to protect the health and safety of our teams, donors and to maintain our essential operations. Please take a moment to review what you can expect when entering a Canadian Blood Services site, below.

Wellness station (Employee-facing) ON

Do not enter this site if you answer YES to any of the following questions:

Have you or anyone you live with travelled outside Canada in the last 14 days?
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 or chills
- difficulty breathing or shortness of breath, cough, sore throat, trouble swallowing
- runny nose/stuffy nose or nasal congestion
- decrease or loss of smell or taste
- nausea, vomiting, diarrhea, abdominal pain
- 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 notified by public health that you should currently be isolating?
- hospitalized with COVID-19 and has it been less than 21 days since your recovery?
Have you had COVID-19 and has it been less than 14 days since your recovery or less than 14 days since you received a positive test result?
Do you live with a person who has COVID-19 or who has recovered from COVID-19 less than 14 days ago or less than 14 days since they received a positive test result?
Are you:
- awaiting test results because you were experiencing symptoms or because you are part of a contact tracing investigation due to contact with a person with COVID-19?
- a health care worker or first responder with occupational exposure to someone with COVID-19 in the last 14 days and did not use the personal protective equipment required of your job?

Wellness station (Employee-facing) BC-AB-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?
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 or chills
- difficulty breathing or shortness of breath, cough, sore throat, trouble swallowing
- runny nose/stuffy nose or nasal congestion
- decrease or loss of smell or taste
- nausea, vomiting, diarrhea, abdominal pain
- 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 notified by public health that you should currently be isolating?
- hospitalized with COVID-19 and has it been less than 21 days since your recovery?
Have you had COVID-19 and has it been less than 14 days since your recovery or less than 14 days since you received a positive test result?
Do you live with a person who has COVID-19 or who has recovered from COVID-19 less than 14 days ago or less than 14 days since they received a positive test result?
Are you:
- awaiting test results because you were experiencing symptoms or because you are part of a contact tracing investigation due to contact with a person with COVID-19?
- a health care worker or first responder with occupational exposure to someone with COVID-19 in the last 14 days and did not use the personal protective equipment required of your job?

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?
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 or chills
- difficulty breathing or shortness of breath, cough, sore throat, trouble swallowing
- runny nose/stuffy nose or nasal congestion
- decrease or loss of smell or taste
- nausea, vomiting, diarrhea, abdominal pain
- 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 notified by public health that you should currently be isolating?
- hospitalized with COVID-19 and has it been less than 21 days since your recovery?
Have you had COVID-19 and has it been less than 14 days since your recovery or less than 14 days since you received a positive test result?
Do you live with a person who has COVID-19 or who has recovered from COVID-19 less than 14 days ago or less than 14 days since they received a positive test result?
Are you:
- awaiting test results because you were experiencing symptoms or because you are part of a contact tracing investigation due to contact with a person with COVID-19?
- a health care worker or first responder with occupational exposure to someone with COVID-19 in the last 14 days and did not use the personal protective equipment required of your job?