top of page
Coat of Arms - Banner.jpg

Covid-19 Health Declaration

Please complete this screening questionnaire for each person in your household who will be attending church.

In the past 14 days, have you been diagnosed with COVID-19?
In the past 14 days, have you had symptoms of COVID-19: fever, dry cough, fatigue, loss of taste or smell?
In the past 14 days, have you been informed by a health unit or mobile app that you may have been exposed to COVID-19?
In the past 14 days to the best of your knowledge, have you been in contact with someone who has tested positive for COVID-19?
Have you travelled outside of Canada in the past 14 days?

Thank you for taking the time to complete our COVID screening tool.

bottom of page