COVID-19 Form

Please call 911 or go directly to your nearest Emergency Department.

2. Do you or the person you are inquiring about have shortness of breath at rest or difficulty breathing when lying down?
YesNo

You should speak with a nurse about your symptoms.

Please call Health Links-Info Santé in Winnipeg at 204-788-8200; toll free elsewhere in Manitoba 1-888-315-9257.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

3. Do you have a new onset of any of the following symptoms: fever, cough, sore throat, shortness of breath and if the patient is an infant, poor feeding and lethargy?
YesNo

3.1 Have you been in contact in the last 14 days with someone that is confirmed to have COVID-19?
YesNo

3.2 Have you had laboratory exposure while working directly with specimens known to contain COVID-19?
YesNo

3.3 Are you a worker or volunteer in a workplace that has been identified as an essential service (includes health care workers, first responders)?

(Note: If the workplace remained open during the shutdown of non-essential workplaces mandated by Public Health Orders, consider the workplace an essential service.)

YesNo

3.4 Do you live or work in a remote and isolated community including all First Nation communities, all northern communities, and closed religious communities, or live or work in a congregate setting such as a correctional facility, shelter, long term care or residential facility, remote work-camp?
YesNo

3.5 Is anyone currently in your household a health care worker, first responder, or a worker in a congregate setting such as a correctional facility, shelter, long term care or residential facility?
YesNo

3.6 Have you been in a large group setting in Manitoba in the last 14 days where someone has been confirmed to have COVID-19, such as a flight, or a large meeting or event?
YesNo

3.7 Have you travelled outside of Manitoba in the last 14 days, excluding personal travel to border communities?
YesNo

3.8 Do you or the person you are inquiring about have a chronic health condition that you are concerned about?
YesNo

3.9 Have you had close contact (face-to-face contact within 2 meters/6 feet) with someone who is ill with respiratory symptoms?
YesNo

Based on your responses you do not need to be tested for COVID-19 at this time.

Anyone who has mild symptoms of a respiratory illness (e.g., fever, cough, runny nose, sore throat) should self-isolate from the day the symptoms started till they no longer have a fever and the other symptoms are gone, with a minimum isolation period of 14 days (2 weeks). This means staying home and keeping away from others.

For more information about caring for yourself at home and self-isolating, visit: manitoba.ca/covid19/factsheets.

Not everyone needs to be tested for COVID-19 because it will not change their care or treatment plan. If your symptoms worsen (e.g., shortness of breath, breathing difficulties), or if you have been in contact with a confirmed case of COVID-19, please contact Health Links-Info Santé at 204-788-8200 or 1-888-315-9257 to receive further advice.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

If you are experiencing severe symptoms or difficulties breathing, call 911 or go to an Emergency Department and tell them you have symptoms of COVID-19.

Please see the self isolation fact sheet for further information manitoba.ca/covid19/factsheets.

Based on your responses you do not need to be tested for COVID-19 at this time.

Anyone who has mild symptoms of a respiratory illness (e.g., fever, cough, runny nose, sore throat) should self-isolate from the day the symptoms started till they no longer have a fever and the other symptoms are gone, with a minimum isolation period of 14 days (2 weeks). This means staying home and keeping away from others.

For more information about caring for yourself at home and self-isolating, visit: manitoba.ca/covid19/factsheets.

Not everyone needs to be tested for COVID-19 because it will not change their care or treatment plan. If your symptoms worsen (e.g., shortness of breath, breathing difficulties), or if you have been in contact with a confirmed case of COVID-19, please contact Health Links-Info Santé at 204-788-8200 or 1-888-315-9257 to receive further advice.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

If you are experiencing severe symptoms or difficulties breathing, call 911 or go to an Emergency Department and tell them you have symptoms of COVID-19.

Please see the self isolation fact sheet for further information manitoba.ca/covid19/factsheets.

You should immediately limit your contact with others and isolate.

You should speak with a nurse about your exposure. Please call Health Links-Info Santé in Winnipeg at 204-788-8200; toll free elsewhere in Manitoba 1-888-315-9257.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

If you are determined to be a close contact of a confirmed case of COVID-19, you will be recommended to self-isolate and will be referred to public health who will be in contact with you to provide more information.

Please see the self isolation fact sheet for further information manitoba.ca/covid19/factsheets.

4. Do you have a new onset of 2 or more of any of the following symptoms: runny nose, muscle aches, fatigue, loss of taste or smell, headache, hoarse voice or nausea, vomiting or diarrhea for more than 24 hours?
YesNo

4.1 Have you been in contact in the last 14 days with someone that is confirmed to have COVID-19?
YesNo

4.2 Have you had laboratory exposure while working directly with specimens known to contain COVID-19?
YesNo

4.3 Are you a worker or volunteer in a workplace that has been identified as an essential service (includes health care workers, first responders)?

(Note: If the workplace remained open during the shutdown of non-essential workplaces mandated by Public Health Orders, consider the workplace an essential service.)

YesNo

4.4 Do you live or work in a remote and isolated community including all First Nation communities, all northern communities, and closed religious communities, or live or work in a congregate setting such as a correctional facility, shelter, long term care or residential facility, remote work-camp?
YesNo

4.5 Is anyone currently in your household a health care worker, first responder, or a worker in a congregate setting such as a correctional facility, shelter, long term care or residential facility?
YesNo

4.6 Have you been in a large group setting in Manitoba in the last 14 days where someone has been confirmed to have COVID-19, such as a flight, or a large meeting or event?
YesNo

4.7 Have you travelled outside of Manitoba in the last 14 days, excluding personal travel to border communities?
YesNo

4.8 Do you or the person you are inquiring about have a chronic health condition that you are concerned about?
YesNo

4.9 Have you had close contact (face-to-face contact within 2 meters/6 feet) with someone who is ill with respiratory symptoms?
YesNo

Based on your responses you do not need to be tested for COVID-19 at this time.

Anyone who has mild symptoms of a respiratory illness (e.g., fever, cough, runny nose, sore throat) should self-isolate from the day the symptoms started till they no longer have a fever and the other symptoms are gone, with a minimum isolation period of 14 days (2 weeks). This means staying home and keeping away from others.

For more information about caring for yourself at home and self-isolating, visit: manitoba.ca/covid19/factsheets.

Not everyone needs to be tested for COVID-19 because it will not change their care or treatment plan. If your symptoms worsen (e.g., shortness of breath, breathing difficulties), or if you have been in contact with a confirmed case of COVID-19, please contact Health Links-Info Santé at 204-788-8200 or 1-888-315-9257 to receive further advice.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

If you are experiencing severe symptoms or difficulties breathing, call 911 or go to an Emergency Department and tell them you have symptoms of COVID-19.

Please see the self isolation fact sheet for further information manitoba.ca/covid19/factsheets.

Based on your responses you do not need to be tested for COVID-19 at this time.

Anyone who has mild symptoms of a respiratory illness (e.g., fever, cough, runny nose, sore throat) should self-isolate from the day the symptoms started till they no longer have a fever and the other symptoms are gone, with a minimum isolation period of 14 days (2 weeks). This means staying home and keeping away from others.

For more information about caring for yourself at home and self-isolating, visit: manitoba.ca/covid19/factsheets.

Not everyone needs to be tested for COVID-19 because it will not change their care or treatment plan. If your symptoms worsen (e.g., shortness of breath, breathing difficulties), or if you have been in contact with a confirmed case of COVID-19, please contact Health Links-Info Santé at 204-788-8200 or 1-888-315-9257 to receive further advice.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

If you are experiencing severe symptoms or difficulties breathing, call 911 or go to an Emergency Department and tell them you have symptoms of COVID-19.

Please see the self isolation fact sheet for further information manitoba.ca/covid19/factsheets.

You should immediately limit your contact with others and isolate.

You should speak with a nurse about your exposure. Please call Health Links-Info Santé in Winnipeg at 204-788-8200; toll free elsewhere in Manitoba 1-888-315-9257.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

If you are determined to be a close contact of a confirmed case of COVID-19, you will be recommended to self-isolate and will be referred to public health who will be in contact with you to provide more information.

Please see the self isolation fact sheet for further information manitoba.ca/covid19/factsheets.

5. Have you been in contact in the last 14 days with someone that is confirmed to have COVID-19?
YesNo

You should immediately limit your contact with others and isolate.

You should speak with a nurse about your exposure. Please call Health Links-Info Santé in Winnipeg at 204-788-8200; toll free elsewhere in Manitoba 1-888-315-9257.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

If you are determined to be a close contact of a confirmed case of COVID-19, you will be recommended to self-isolate and will be referred to public health who will be in contact with you to provide more information.

Please see the self isolation fact sheet for further information manitoba.ca/covid19/factsheets.

6. Have you had laboratory exposure while working directly with specimens known to contain COVID-19?
YesNo

You should immediately limit your contact with others and isolate.

You should speak with a nurse about your exposure. Please call Health Links-Info Santé in Winnipeg at 204-788-8200; toll free elsewhere in Manitoba 1-888-315-9257.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

If you are determined to be a close contact of a confirmed case of COVID-19, you will be recommended to self-isolate and will be referred to public health who will be in contact with you to provide more information.

Please see the self isolation fact sheet for further information manitoba.ca/covid19/factsheets.

7. Have you been in a large group setting in Manitoba in the last 14 days where someone has been confirmed to have COVID-19, such as a flight, or at a large meeting or event?
YesNo

You should speak with a nurse about your exposure.

Please call Health Links-Info Santé in Winnipeg at 204-788-8200; toll free elsewhere in Manitoba 1-888-315-9257.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

8. Have you travelled outside of Manitoba in the last 14 days, excluding personal travel to border communities?

(Note that workers who routinely travel inter-provincially for work and those involved in commercial transportation of goods and services are excluded)

YesNo

All returning travellers are asked to self-isolate and self-monitor for symptoms.

You should limit your contact with others and self-monitor for signs and symptoms for 14 days following your return to Manitoba. Especially avoid close contact with those at higher risk for severe illness, such as individuals over age 65 years or those with chronic health conditions.

You should not go to work and children should not go to school or daycare while self-isolating.

If you develop a fever, cough, shortness of breath, difficulty breathing or any other symptoms during the 14-day self-isolation period, or require further advice, please contact Health Links-Info Santé at 204-788-8200 or 1-888-315-9257.

We are experiencing heavy call volumes and will get to your call as quickly as we can.

Please see the self isolation fact sheet for further information manitoba.ca/covid19/factsheets.

9. Have you had close contact (face-to-face contact within 2 meters/6 feet) with someone who is ill with respiratory symptoms?
YesNo

Based on your responses you do not need to be tested for COVID-19.

Anyone who develops mild symptoms of a respiratory illness (e.g., fever, cough, runny nose, sore throat) should self-isolate from the day the symptoms started till they no longer have a fever and the other symptoms are gone, with a minimum isolation period of 14 days (2 weeks). This means staying home and keeping away from others.

For more information about caring for yourself at home and self-isolating, visit: manitoba.ca/covid19/factsheets.

Not everyone needs to be tested for COVID-19 because it will not change their care or treatment plan.

If you develop symptoms which become worse or you have been in contact with a confirmed case of COVID-19, please call Health Links - Info Santé in Winnipeg at 204-788-8200; toll free elsewhere in Manitoba 1-888-315-9257.

We are experiencing heavy call volumes and will get to your call as quickly as we can.