Covid-19 Self Assessment

Prior to entering this church please complete the assessment below, and submit.
If you answer yes to any of the questions below, do not enter the building
and complete an on-line assessment for recommendations.

https://covid-19.ontario.ca/self-assessment/

Contact Us

1. Do you currently have one or more of the COVID-19 symptoms below that are new or worsening? If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild fatigue, muscle aches and/or joint pain that only began after vaccination, select “No.”

Symptoms should not be chronic or related to other known causes or conditions.

  • fever and/or chills
  • cough or barking cough (croup)
  • shortness of breath
  • decrease or loss of smell or taste
  • fatigue and/or muscle aches/joint pain (for adults)
  • nausea/vomiting, and/or diarrhea (for<18 years of age)

2. Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? This can be because of an outbreak or contact tracing.

3. Do you live with someone who has been told by a doctor, health care provider, or public health unit that they should currently be isolating? If you are fully immunized or have tested positive for COVID-19 in the last 90 days and since been cleared, select “No.”

4. In the last 14 days, have you travelled outside of Canada AND been advised to quarantine (as per the federal quarantine requirements)?

5. In the last 10 days, have you been identified as a “close contact” of someone who currently has COVID-19? If public health has advised you that you do not need to self-isolate, select “No.”

6. In the last 10 days, have you tested positive on a rapid antigen test or a homebased self-testing kit? If you have since tested negative on a lab-based PCR test, select “No.”

7. In the last 10 days, have you received a COVID Alert exposure notification on your cell phone? If you have since tested negative on a lab-based PCR test, select "No."

8. In the last 14 days, has someone in your household (someone you live with) travelled outside of Canada AND been advised to quarantine (as per the federal quarantine requirements)? If you are fully immunized or have tested positive for COVID-19 in the last 90 days and since been cleared, select “No.”

9. In the last 10 days, has someone in your household (someone you live with) been  identified as a ”close contact” of someone who currently has COVID-19 AND advised by a doctor, healthcare provider or public health unit to self-isolate? 

If you are fully immunized or have tested positive for COVID-19 in the last 90 days and since been cleared, select “No.”


If you answer yes to any of the questions, please leave the building and complete an on-line assessment for recommendations.

https://covid-19.ontario.ca/self-assessment/

I attest that I have answered all the screening questions truthfully as I have understood them.  While in Centennial United Church I will maintain social distancing to the best of my ability and will keep my mask over my chin, mouth and nose at all times and follow all the Covid-19 protocols as mandated by the church, government & SMDHU.