Your Name (required)
Your Phone Number (10-digit # required)
Your Email (required)
Your Pet's Name (required)
Pet's Date of Birth (required)
Choose any/all that are new, worsening, and not related to a medical condition you already have.
FeverChillsCough that's new or worseningBarking cough, making a whistling noise when breathingShortness of breathSore throatDifficulty swallowingRunny noseStuffy or congested noseDecrease or loss of taste or smellPink eyeHeadache that's unusual or long lastingNausea/vomiting, diarrhea, stomach painMuscle aches that are unusual or long lastingExtreme tiredness that is unusualFalling down oftenSluggishness or lack of appetiteNone of the above
This includes getting a COVID Alert exposure notification.
Close physical contact means any of the following while not wearing the appropriate personal protective equipment (PPE):
This does not include essential workers who cross the Canada-US border regularly.
Please note: If after sending the form, you do not see a confirmation, please scroll up to see if you missed a required field. (It will be marked with a red "X".