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RCFS Participant COVID-19 Screening

If this is a medical emergency, call 9-1-1. Advise them of your symptoms and if you have recently travelled.

The self-assessment is only meant as an aid and cannot diagnose you. Consult a health care provider if you have medical questions.

I certify that the information I am about to submit in response to this COVID-19 self-assessment is true and correct to the best of my knowledge.
I acknowledge that the City of Ottawa will retain a record of whether I pass the screening and use that information for the purposes of administering the COVID-19 screening process and complying with measures that are stipulated under the Reopening Ontario (A Flexible Response to COVID-19) Act, 2020 and occupational health and safety legislation. I further consent to the City of Ottawa disclosing to my employer / manager / supervisor (if applicable) whether or not I pass the screening or am required to self-isolate, as may be appropriate. Any questions about the collection, use, and disclosure of my personal information may be directed to the HR Service Centre, HRServiceCentre@Ottawa.ca, 613-580-2424 ext. 47411.