COVID-19 Symptom-based Screening Questionnaire

This questionnaire aims to screen workers before entering their workplace to exclude those who are symptomatic and who have not had contact with a known case of COVID-19 already followed by public health authorities.

The questionnaire is intended to be completed by employees themselves on their workplace (other than health care facilities) to ensure the rapid removal of workers potentially infected with COVID-19 and to prevent its transmission to others in the workplace.

Employees with positive answers in their questionnaires should call 1 877 644 4545 or 811 to receive instructions (alternatively, check for local phone numbers). When calling, the person should specify that he/she is a worker.

Having one or more of the following symptoms justifies immediate removal from the workplace
Do you feel feverish, have flu-like chills, or a fever with an oral temperature of 38.1°C (100.6°F) or higher? Yes    No
Have you had a sudden loss of smell without nasal congestion (stuffy nose), with or without loss of taste?  Yes    No
Do you have a cough or has a chronic cough gotten worse recently? Yes    No
Are you experiencing trouble breathing or shortness of breath? Yes    No
Do you have a sore throat? Yes    No
Having at least two (2) of the following symptoms justifies immediate removal from the workplace
Stomach ache Yes    No
Nausea or vomiting Yes    No
Diarrhea Yes    No
Runny nose or nasal congestion (stuffy nose) of unknown cause Yes    No
Unusually intense fatigue for no obvious reason Yes    No
Significant loss or appetite Yes    No
Unusual or unexplained muscle pain, or stiffness (not related to physical activity) Yes    No
Unusual headache  Yes    No


  • An intermittent fever (in other words, one that comes and goes) also meets this criterion. A single oral measurement of body temperature of 38.1°C or above also meets this criterion1.


  • In a few instances, people can develop a regular cough (ex. chronic smokers). A regular cough alone does not meet this criterion, unless any change occurs (ex. increased frequency or recent sputum).

Difficulty breathing:

  • Some medical conditions that are not related to COVID-19 may explain the breathing difficulties experienced by some people (ex. asthmatics). Any breathing difficulty that is not related to pre-existing conditions meets this criterion.

Sudden loss of smell:

  • Sudden loss of the sense of smell without nasal congestion, with or without loss of taste, meets this criterion, either alone or in combination with other symptoms.

1 Please refer to the information in Annex for more on how to use body temperature as a sorting tool at the workplace.

Using the COVID-19 Symptom-based Screening Questionnaire

  1. It is suggested that workers self-assess their symptoms before leaving home.
  2. In addition to self-declaration of symptoms, it is recommended that the questionnaire be administered at the beginning of the shift or alternatively that a verbal validation is obtained from all workers ensuring that the questionnaire is negative. It can also be administered at other times deemed appropriate: breaks, meals or end of shift.
  3. Workers indicating symptoms (positive questionnaire answers) or who develops symptoms at work should be removed from the workplace immediately and isolated in a separate room. Ask symptomatic workers to wear a procedure mask2 and to wash their hands. Workers should then call 1 877 644 4545 (or local number) or 8-1-1 for instructions on how to safely leave work and receive the necessary follow-ups from public health authorities. In case of an emergency (e.g., difficulty breathing), call 9-1-1 and inform the dispatcher of a suspected case of COVID-19 in the building.
  4. Keep a detailed record of all workers (whether or not they come from staffing agencies), including the following details that can be later used to conduct outbreak investigations: date of birth, days worked, position held during each shift, mobile phone number and email address.
  5. It is also suggested to immediately identify all individuals who have been in close contact with the symptomatic worker in the last 48 hours before the onset of symptoms until their identification and the isolation of said worker, so that they can be isolated as soon as possible, according to public health recommendations, if the case of the symptomatic worker is confirmed.
  6. In the event that the symptomatic worker is confirmed to be COVID-19 positive, preventive identification of close contacts will have helped to reduce the risk of transmission in the workplace and facilitate outbreak investigations by public health authorities.
  7. Lifting isolation of any symptomatic worker should be managed by the competent health authorities in each region.
  8. Each close contact removed from the workplace which then becomes a confirmed COVID-19 case must comply with public health recommendations before returning to work.
  9. However, if the symptomatic worker receives a COVID-19 negative test result from the competent health authorities in his/her region, namely public health or designated screening or assessment clinics, he/she shall notify his/her employer; this worker and all his/her asymptomatic contacts may return to work.

2 Refer to COVID 19 : Recommandations du masque médical en milieux de travail, hors milieux de soins [French only].

The following are considered close contacts:

  • Workers having shared a car (personal car, taxi, shuttle, bus, etc.) during the period of contagiousness of the symptomatic worker (48 hours before onset of symptoms and until self-isolation of the symptomatic worker), and if they were sitting less than 2 meters apart for a cumulative duration of more than 15 minutes per 24-hour period, without a physical barrier (separator between workers) or without the appropriate personal protective equipment (procedural mask worn by all occupants of the vehicle, with or without eye protection/visor).
  • Workers who reside under the same roof as the symptomatic worker.
  • Employees working without a physical barrier (separator between workers) or without the appropriate personal protective equipment (procedural mask worn by all occupants of the vehicle, with or without eye protection/visor) and that have been within 2 metres of distance of the symptomatic worker during his/her period of contagiousness (48 hours before onset of symptoms and until self-isolation of the symptomatic worker), for a cumulative period of over 15 minutes per 24-hour period.
    • If the symptomatic worker is confirmed to be COVID-19 positive, public health authorities will re-evaluate his/her close contacts and the decision to remove them or not may differ from the initial removal made preventively by the institution.
    • If prescription glasses are necessary and, due to excessive fogging, the wearing of the procedure mask is not possible for safety reasons, the use of a visor alone is accepted. Any contact should then be considered as close contact.
  • A first-aid worker in contact with secretions (hands and/or face) from a worker who may be COVID‑19 positive.


Body temperature measurement at the workplace as a staff sorting tool (triage)

Body temperature measurement alone is not recommended to sort workers at the entrance of establishments.

Occupational physicians in the public health network favor the use of a symptom-based screening questionnaire without taking body temperature.

Taking body temperature in the workplace is not recommended for the following reasons:

  1. Body temperature fluctuates in people with COVID-19, and some will not develop any fever during the course of the disease;
  2. Several things can affect body temperature: taking medicines (e.g., acetaminophen), drinking hot or cold drinks just before reading is taken, measuring temperature in places where the room temperature is not controlled or is too cold (outdoors, for example), normal changes in body temperature throughout the day, etc.;
  3. There is a risk of infection of the personnel responsible of taking body temperature measurements, as this task involves close contact with workers;
  4. The personnel in charge of taking body temperature readings must be trained to safely obtain reliable and reproducible results;
  5. Taking body temperature readings of each and every employee is time-consuming (time needed to get a reliable temperature reading, time to clean and disinfect the equipment used, etc.);
  6. There is a risk of crowding or queuing when taking the body temperature of several employees at once.

If an employer still wants to use body temperature measurements to screen employees at the entrance of their workplace, a symptom-based screening questionnaire must be filled prior to work. If applicable:

  • A single body temperature reading of 38,1°C or higher justifies immediate removal of the employee, asking them to wear a procedural mask (if not already worn), to isolate in a separate room, and call 1 877 644 4545 (or 8-1-1, available in French and English).
  • It will be necessary to train the designated personnel for this task in the following aspects: cleaning and disinfecting the equipment used, obtaining reliable readings, using adequate protection (procedure mask, gloves and visor), and adopting a strict hand hygiene before and after removing the personal protective equipment.
COVID-19 Symptom-based Screening Questionnaire



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