Step 1 of 9 11% Name* First Last Email* Enter Email Confirm Email 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 issues? Call 911 if you are.* No Yes Are you currently experiencing any of these symptoms?Are you currently experiencing any of these symptoms?* Fever and/or chills Cough or barking cough (croup) Shortness of breath Sore throat Difficulty swallowing Runny or stuffy/congested nose Decrease or loss of taste or smell Pink eye Headache Digestive issues like nausea/vomiting, diarrhea, stomach pain Muscle aches Extreme tiredness Falling down often None of the above Are you in any of these at-risk groups? 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, immunodeficiency disorder)Having a chronic (long-lasting) health condition(for example, diabetes, emphysema, asthma, heart condition, COPD)Regularly going to a hospital or health care setting for a treatment(for example, dialysis, surgery, cancer treatment)Are you in any of these at-risk groups?* No Yes In the last 14 days, have you been identified as a “close contact” of someone who currently has COVID-19? In the last 14 days, have you been identified as a “close contact” of someone who currently has COVID-19?* No Yes In the last 14 days, have you received a COVID Alert exposure notification on your cell phone? If you already went for a test and got a negative result, select "No." In the last 14 days, have you received a COVID Alert exposure notification on your cell phone?* No Yes In the last 14 days, have you been in close physical contact with someone who either: is currently sick with a new cough, fever, difficulty breathing, or other symptoms associated with COVID-19? or returned from outside of Canada in the last 2 weeks? Close physical contact means any of the following while not wearing the appropriate personal protective equipment (PPE): being less than 2 metres away in the same room, workspace, or area living in the same home being in the same classroom In the last 14 days, have you been in close physical contact with someone who either:* No Yes In the last 14 days, have you travelled outside of Canada? In the last 14 days, have you travelled outside of Canada?* No Yes Do you need a COVID-19 test for a specific reason? This can include: visiting or working in a nursing or long-term care home working or living in a homeless shelter or other congregate setting being an international student or farm worker Do you need a COVID-19 test for a specific reason?* No Yes
