Please complete this self-assessment prior to coming to our clinic.  It is also available at https://covid-19.ontario.ca/self-assessment

Are you currently experiencing any of these issues?  Call 911 if you are.

Severe difficulty breathing  (struggling for each breath, can only speak in single words)

Severe chest pain (constant tightness or crushing sensation)

Feeling confused or unsure of where you are

Losing consciousness

Are you currently experiencing any of these symptoms? Choose any/all that apply.

Fever(feeling hot to the touch, a temperature of 37.8 degrees Celsius or higher)

Chills

Cough that's new or worsening (continuous, more than usual)

Barking cough, making a whistling noise when breathing (croup)

Shortness of breath (out of breath, unable to breathe deeply)

Sore throat

Difficulty swallowing

Runny nose (not related to seasonal allergies or other known causes or conditions)

Stuffy or congested nose (not related to seasonal allergies or other known causes or conditions)

Lost sense of taste or smell

Pink eye (conjunctivitis)

Headache that’s unusual or long lasting

Digestive issues (nausea/vomiting, diarrhea, stomach pain)

Muscle aches

Extreme tiredness that is unusual (fatigue, lack of energy)

Falling down often

For young children and infants: sluggishness or lack of appetite

None of the above

Are you in any of these at-risk groups?

70 years old or older

getting treatment that compromises (weakens) your immune system

(for example, chemotherapy, medication for transplants, corticosteroids, TNF inhibitors)

having a condition that compromises (weakens) your immune system

(for example, lupus, rheumatoid arthritis, other autoimmune disorder)

having a chronic (long-lasting) health condition

(for example, diabetes, emphysema, asthma, heart condition)

regularly going to a hospital or health care setting for a treatment

(for example, dialysis, surgery, cancer treatment)

In the last 14 days, have you been in close physical contact with someone who tested positive for COVID-19?

Close physical contact means the following:

    -being less than 2 metres away in the same room, workspace, or area for over 15 minutes

    -living in the same home

In the last 14 days, have you been in close physical contact with a person who either:

• is currently sick with a new cough, fever, or difficulty breathing?

 or

• returned from outside of Canada in the last 2 weeks?

Close physical contact means:

    -being less than 2 metres away in the same room, workspace, or area for over 15 minutes

    -living in the same home

Have you travelled outside of Canada in the last 14 days?

1.  Be cautious outside and keep a distance from others

This is called physical distancing.

Keep a distance of at least 6 feet (2 metres) from people you do not live with to slow the spread of the virus.

The best way to stop the spread is by staying home as much as you can and washing your hands.

Wearing a face covering or mask

use one when you cannot keep a distance from people (like in stores or on public transit)

cover both your mouth and nose

do not touch it without washing or sanitizing your hands first

learn how to wear and use face coverings and masksThis link will open in a new window.

Shopping in person

use curbside pickup or get items delivered as much as you can

wear a face covering or mask if you go into retail or grocery stores

keep a distance of at least 6 feet (2 metres) from people you do not live with

Going to work

work from home (if possible)

if you cannot work from home, make sure you and your company are taking the right safety precautions to avoid the spread of the virus

discuss with your manager and occupational health and safety representative

Walks and exercise

you can go on neighbourhood walks or take the dog out

you can jog or bike around

keep a distance of at least 6 feet (2 metres) from people you do not live with

Parks and squares

avoid crowds and big groups

keep a distance of at least 6 feet (2 metres) from people you do not live with

Friends and family you do not live with

contact them over the phone or online as much as you can

keep a distance of at least 6 feet (2 metres) if you meet them in person

meet outside or in a well-ventilated space

2.  Monitor your health

Visit an assessment centre if you:

start feeling sick

come into close physical contact with someone who has symptoms

feel like you need a test

Roommates and family you live with

they should monitor their health too

young children might have less specific symptoms like sluggishness or lack of appetite