COVID-19 Survey

COVID-19 Survey (with map)

Required Screening Questions

1. Do you have any of the following new or worsening symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions.
Fever or chills *
Difficulty breathing or shortness of breath *
Cough *
Sore throat, trouble swallowing *
Runny nose/stuffy nose or nasal congestion *
Decrease or loss of smell or taste *
Nausea, vomiting, diarrhea, abdominal pain *
Not feeling well, extreme tiredness, sore muscles *


2. Have you travelled outside of Canada in the past 14 days? *

Close Contact

3. Have you had any close contact with a confirmed or probable case of COVID-19? *

Results of Screening Questions

  • If you have answered NO to all questions from 1 through 3, you have passed and Vacu-Man can safely enter your workplace or home.
  • If you have answered YES to any questions from 1 through 3, you have not passed and Vacu-Man is not permitted to enter your workplace or home (including any outdoor or partially outdoor areas). It is advised that you should self-isolate immediately and contact your health care provider or Telehealth Ontario (1 866-797-0000) to find out if you need a COVID-19 test.