Ottawa Outdoor Club

COVID-19 health screening questionnaire

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Please answer the following COVID-19 screening questions:

  1. Have you been out of the country in the last two weeks?
  2. Over the past 14 days, have you been exposed to anyone with a positive COVID-19 test or been with anyone who is currently self-isolating?
  3. Over the past two weeks, have you been in close physical contact with anyone who has been exposed to somebody suffering from COVID-19 during these two weeks?
  4. Are you suffering from any respiratory symptoms? New or worsening cough or shortness of breath?
  5. Have you been suffering from fever, chills, sore throat, or runny nose* or nasal congestion*? (* in the absence of underlying reason for these symptoms such as seasonal allergies and post-nasal drip)
  6. Do you have any gastrointestinal symptoms such as nausea, vomiting, or diarrhea?

Due to the still evolving knowledge about COVID-19 and its symptoms, please interpret these questions expansively.

If you answered “yes” to any of the above questions, you are not to participate in the outing, and you should follow up as recommended by the appropriate authorities.

If you participate in this outing, you agree to inform the trip leader should you come down with any of the above symptoms within two weeks of the end of the outing.

In your response regarding the COVID-19 screening questions, you only need to confirm that you answered "no" to all of the questions.  For example, "I answered no to all of the COVID-19 questions," or something similar.  You don't need to enumerate each question and answer in your response.