STFC COVID-19 Screening
To be completed 12 hours or less prior to arrival. Must be completed prior to entering the flight centre premises. Form Last updated 01 MAR 2022
Today's Date
Name
First Name
Last Name
Phone Number
-
Area Code
Phone Number
In the last 5 days, have you experience any of the following symptoms? Fever or chills, new cough, difficulty breathing, loss of taste or smell, muscle aches/pains, extreme tiredness, sore throat, runny/congested nose, headache, nausea, vomiting or diarrhea.
Yes
No
Have you traveled outside of Canada in the last 14 days and been instructed to isolate or quarantine?
Yes
No
Has a doctor, health care provider or public health unit advised you that you should be isolating (staying at home)?
Yes
No
In the last 5 days, have you tested positive for COVID-19?
Yes
No
In the last 5 days, have you been identified as a "close contact" of someone that currently has COVID-19 or symptoms of COVID-19?
Yes
No
Submit
Should be Empty: