Daily COVID-19 - Clients Client Name * Date * Have you travelled outside Canada within the last 14 days? * Yes No Have you been identified by Public Health as a close contact of someone with COVID-19? * Yes No Have you been told to isolate by Public Health? * Yes No Are you experiencing Fever, Chills, Cough or any other COVID-19 related symptoms? Yes No Temperature has been checked and is less than 38 degrees celsius. Yes No By signing you agree that to the best of your knowledge you are in good health and COVID-19 free. Clear If you are human, leave this field blank. Submit
