COVID-19 Symptom Reporting

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Please complete this form if you experience two or more of the following symptoms: fever; sudden loss of sense of smell without nasal congestion, with or without loss of taste; major fatigue; significant loss of appetite; general muscle pain (not related to physical exertion); headache; cough (new or worse); shortness of breath; difficulty breathing; sore throat; runny nose or nasal congestion (stuffy nose) of unknown cause; nausea; vomiting; diarrhea; stomach aches.

What is your full name *

Which delegation are your a part of? If you are an individual delegate please indicate that. *

What is your email address? *

Which committee are you in? *

DISEC

UFC

The First Round Table Conference

The 2022 Metropolitan Gala Planning Committee

Scandal, Corruption and City Hall: Gérald Tremblay's Third Term

Money Heist

Bombardier Board of Directors

JCC - Labour

JCC - National Party

What symptoms are you experiencing? *

Fever

Sudden loss of sense of smell without nasal congestion, with or without loss of taste

Major fatigue

Significant loss of appetite,

General muscle pain (not related to physical exertion),

Headache

Cough (new or worse)

Shortness of breath

Difficulty breathing

Sore throat

Runny nose or nasal congestion (stuffy nose) of unknown cause

Nausea

Vomiting

Diarrhea

Stomach aches

Other:

Required

When did you start experiencing the symptoms? *

YYYY

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