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Required Covid-19 Screening

  • Employees, providers, students, children and essential visitors in schools and child care settings.
  • Please note that the self-screening tool has been modified as of October 5th 2021.
  • The North Bay-Parry Sound District Health Unit has updated its “Schools/Child Care and COVID-19” information page.
  • Please answer the following questions: Check the appropriate box. Thank you.

  • The symptoms listed here are the symptoms most commonly associated with COVID-19.

    If you have these symptoms, you should isolate and seek testing. Please note that rapid antigen testing is not to be used for those with symptoms of COVID-19 or for contacts of known COVID-19 cases.

    Anyone who is sick or has any symptoms of illness, including those not listed below, should stay home and seek assessment from their health care provider if needed.

    Choose any/all that are new, worsening, and not related to other known causes or conditions you already have.

  • • You are fully vaccinated against COVID-19 (it has been 14 days or more since your final dose of either a two-dose or a one-dose vaccine series)

    • You have tested positive for COVID-19 in the last 90 days (and since been cleared)

    If YES, skip questions 4, 5 and 6

    Personal health information is not collected when you complete this screening tool. The purpose of this question is to provide accurate isolation instructions, which are based on vaccination status and previous infection history.

  • Children (<18 years old): fever and/or chills, cough or barking cough, shortness of breath, decrease or loss of taste or smell, nausea, vomiting and/or diarrhea.

    Adults: (≥18 years old): fever and/or chills, cough or barking cough, shortness of breath, decrease or loss of taste or smell, tiredness, muscle aches.

    If the individual experiencing symptoms received a COVID-19 vaccination in the last 48 hours and is experiencing only mild fatigue, muscle aches, and/or joint pain that only began after vaccination, select “No.”
  • If you have answered yes to any of the above questions or have refused to answer:
  • Your child will not be permitted to attend the child care center.
  • By submitting this form I certify that the above statements are true and valid.
  • Date Format: MM slash DD slash YYYY
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