Health Declaration

Please fill out the following health declaration form

Submissions are valid up to 24 hours prior to arrival.

First Name

Last Name

Email

My body temperature is lower than 98.6°F/ 37.5°C

Have you had a Covid-19 test?

No

Yes

Are you experiecing any of the following:

Fever or chills

Cough

Difficulty breathing

Sore throat

Loss of smell or taste

Headache

Extreme fatigue

Diarrhea

Loss of appetite

Nause or vomiting

Body aches

None of the above

Have you returned to Canada from any country (including the United States) withing the last 14 days?

No

Yes

I confirm that I have not been in close contact with anyone with confirmed Covid-19 in the last 14 days (A close contact is someone confirmed to have COVID-1

I confirm that the information given in this form is true

Date

Initials

Thanks for submitting!

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