Covid-19 Health Declaration

How are you feeling today?

1. Are you experiencing any of the following new or worsening symptoms?
2. Have you traveled outside Canada, including the United States, within the last 14 days?
3. Did you provide care or have close contact with a person with COVID-19 (probable or confirmed) while they were ill (cough, fever, sneezing, or sore throat) within the last 14 days?
4. Did you have close contact with a person who travelled outside of Canada in the last 14 days who has become ill (cough, fever, sneezing, or sore throat)?
5. Have you or anybody in your home had contact with someone who is being tested for COVID-19 or who has been diagnosed with COVID-19.

#5-425 Columbia Ave Castlegar B.C. V1N 2A8

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