Gym 41 COVID Screening
Mandatory to enter building
What is your name? *
Are you currently experiencing any of these issues? Call 911 if you are: *
Required
How old are you? *
What are the first 3 characters of your postal code? *
Are you currently experiencing any of these symptoms? (Choose any/all that are new, worsening, and not related to other known causes or conditions.) *
Required
Are you in any of these at-risk groups? *
Required
In the last 14 days, have you been identified as a “close contact” of someone who currently has COVID-19? (This includes getting a COVID Alert exposure notification.) *
In the last 14 days, have you been in close physical contact (less than 2m distance away, living in same room, same classroom) with someone who either: *
Required
Have you travelled outside of Canada in the last 14 days? (This does not include essential workers who cross the Canada-US border regularly.) *
Do you need a COVID-19 test for a specific reason? *
Required
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