In response to COVID-19, we have made a secure online form for contact tracing. Click Here

Contact Tracing

"*" indicates required fields

Name*
MM slash DD slash YYYY
Do you have new or worsening symptoms?
Fever and/or chills*
Cough and/or barking cough*
Shortness of breath*
Decrease or loss of taste and/or smell*
Sore throat or trouble swallowing*
Runny or stuffy nose*
Abdominal pain that is persistent or ongoing (not related to known causes or conditions e.g., menstrual cramps, gastroesophageal reflux disease)*
Headache that is unusual or long lasting*
Conjunctivitis (pink eye)*
A decreased or lack of appetite*
For adults (18 years of age or older): Tiredness, muscle aches or joint pain*
For children (under 18 years of age): Nausea, vomiting and/or diarrhea*
In the last 14 days, have you or someone you live with travelled outside of Canada AND been advised to quarantine (as per federal quarantine requirements)?*
Has a doctor, healthcare provider, or public health unit told you that you should currently be isolating (staying at home)?*
In the last 10 days, have you been identified as a “close contact” of someone who currently has COVID-19?*
In the last 10 days, have you tested positive on a rapid antigen test or a home-based self-testing kit?*
In the last 10 days, have you received a COVID Alert exposure notification on your cell phone?*
In the last 10 days, has someone you live with been identified as a “close contact” of someone who currently has COVID-19 AND advised by a doctor, healthcare provider or public health unit to self-isolate?*
Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?*
If “yes” to any of the above, do not enter. Go home, self-isolate and seek testing.
This field is for validation purposes and should be left unchanged.

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Address: 328 Princess St. | Kingston, ON K7L 1B6
Phone: (613) 545-3689
Email: envyhairstudioygk@gmail.com

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