Effective April 8, Ontario enters a province-wide Stay-at-Home order. SHIP will continue to support our clients and communities but will work in a reduced/amended capacity.

The completion of this COVID-19 screening assessment is a commitment to my health and to the health and well-being of others.

Please complete the form below ensuring your responses are honest and provide an accurate reflection of your current health condition.


SHIP COVID-19 Screening Assessment for Staff
I am currently experiencing the following symptoms: *
Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms? *
Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? *
In the last 14 days, have you or anyone you live with travelled outside of Canada? *
In the last 14 days, have you been identified as a "close contact" of someone who currently has COVID-19? *
In the last 14 days, have you received a COVID Alert exposure notification on your cell phone? (If you already went for a test and got a negative result, select "No" ) *