Are you experiencing any of the following symptoms that are unusual to you:check all that apply Fever Cough Shortness of breath Sore throat Headache Muscle of joint pain Chills Runny nose Loss of sense of smell or taste Having a hard time waking up Feeling confused Lost consciousness Have you been exposed to someone who is under investigation for COVID-19 or has been confirmed as having COVID-19 within the last 14 days?*YesNoHave you been outside of Saskatchewan in the last 14 days?*YesNoAre you volunteering or working in a care home or hospital? Has the care home or hospital indicated any reason that you can not continue work due to any symptoms related to the COVID-19 virus?*YesNoLast Name* Last Mobile Phone Number*Please call 306 665 1962 and let us know which question you answered YES to Expiry Date MM DD YYYY NameThis field is for validation purposes and should be left unchanged.