COVID-19 Screening Tool
Please complete this form before coming to class
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Name *
1. Do you have a new onset or worsening of any ONE of the following symptoms:  fever >38 degrees C or chills, cough, sore throat/hoarse voice, shortness of breath/breathing difficulties, loss of taste or smell, vomiting or diarrhea for more than 24 hrs *
2. Do you have a new onset or worsening of any TWO of the following symptoms? Runny nose, muscle aches, fatigue, conjunctivitis, headache, skin rash of unknown cause, nausea or loss of appetite *
3. Has anyone in your household been told to isolate or is anyone in your household sick?
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4. Have you been in contact in the last 14 days with someone that is confirmed to have COVID-19? *
5. Have you had exposure in a work or public setting? *
6. Have you received a notification from the COVID Alert app that you may have been exposed to COVID-19? *
7. Have you or anyone in your house travelled outside of Manitoba in the last 14 days? *
Did you answer "YES" to any of these questions?
If you did, please unsign from your class and do not attend.

If you develop symptoms of a respiratory illness (e.g. fever, cough, runny nose, sore throat), please call Health Links-Info Santé at 204-788-8200; toll free elsewhere in Manitoba 1-888-315-9257.

Anyone who has symptoms of COVID-19 should self-isolate from the day the symptoms started till they no longer have a fever and the other symptoms are gone, with a minimum isolation period of 14 days (2 weeks). This means staying home and keeping away from others.


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