Skip to main content
History & Land Acknowledgement
What We Believe
Board of Directors
In Home/Residential Care
Grief & Bereavement Support
Tools & Resources
Annual General Meeting
Hike for Hospice
Ways to Give
Ways to Raise
COVID-19 Visitor Screening
Determine whether or not a visitor can enter the premise based on recent actions pertaining to COVID.
" indicates required fields
Please enter your name
Are you fully vaccinated against COVID-19 and possess proof of vaccination?
14 days or more must have elapsed since your final dose to be considered fully vaccinated.
Have you received a booster dose of the vaccine?
This will be your third vaccination shot.
Have you tested positive for COVID-19 within the last 90 days?
Select no if you have been medically cleared.
Have you travelled outside of Canada in the last 14 days and been instructed to quarantine per federal regulatation?
Have you been instructed by a medical professional to isolate or stay at home?
This can be due to an outbreak or contact tracing.
In the last 10 days, have you tested positive for COVID-19 with a rapid antigen test or home-based self-testing kit?
You can select no if you have since tested negative with a lab-based PCR test.
Today's date is
When was the last time you were tested for COVID-19?
Please leave the field blank if you have never been tested for COVID-19.
MM slash DD slash YYYY
Are you currently experiencing any of the following symptoms
Please choose any symptoms that are currently present and/or worsening that are not related to a previously known condition
Fever and/or chills
Shortness of breath
Decrease/loss of taste or smell
Muscle aches/joint pain
None of the above
This field is for validation purposes and should be left unchanged.