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COVID-19 ALBERTA HEALTH DAILY CHECKLIST

Daily Fit for Work or Visitor Screening Questionnaire

This tool was developed to support Albertans in protecting others and reducing the risk of transmission of COVID-19.

Screening Questions for all ages:

 
Example: John D
Helpful in case we need to contact you. Please note this site is not password protected.
 


Have you traveled outside Canada in the last 14 days?
 


Have you had close contact with a case 1 of COVID-19 in the last 14 days? Face-to-face contact within 2 metres for 15 minutes or longer, or direct physical contact such as hugging.
 


Do you have any new onset (or worsening) of the following symptoms: Fever; Cough; Shortness of breath; Runny nose; Sore throat; Chills; Painful Swallowing; Nasal congestion; Feeling unwell/fatigued; Nausea/vomiting/diarrhea; Unexplained loss of appetite; Loss of sense of taste or smell; Muscle/joint aches; Headache; Pink eye
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