COVID 19 Screening
Please answer the following questions to visit Eli Logistics.
Contact Information
First name
Valid first name is required.
Last name
Valid last name is required.
Email
Please enter a valid email address .
Phone Number
Please enter a valid phone .
Please Answer the following Questions Yes or NO
1. Do you have any of the following
new or worsening
symptoms or signs? Symptoms should not be chronic or related to other known causes or conditions.
Fever or chills
Yes
No
Difficulty breathing or shortness of breath
Yes
No
Cough
Yes
No
Sore throat, trouble swallowing
Yes
No
Runny nose/stuffy nose or nasal congestion
Yes
No
Decrease or loss of smell or taste
Yes
No
Nausea, vomiting, diarrhea, abdominal pain
Yes
No
Not feeling well, extreme tiredness, sore muscles
Yes
No
2. Have you travelled outside of Canada in the past 14 days?
Yes
No
3. Have you had close contact with a confirmed or probable case of COVID-19?
Yes
No
Submit
