COVID Assessment and Referral
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If you are completing this form on behalf of someone else, (i.e. your child, a family member or patient), please answer the following questions from their perspective rather than your own.

Please select the symptoms that you are currently experiencing












 OR

In the last 14 days, have you been in close contact with a known case of COVID-19?

Have you received a notification from the COVID Alert app that you may have been exposed to COVID-19?

Are you a traveller arriving to Newfoundland and Labrador who needs a COVID-19 test? (i.e. unvaccinated or partially vaccinated traveller needing a test to leave self-isolation)

Do you require a COVID-19 test as a result of an advisory from Public Health? (e.g., a flight advisory or a public place connected to a COVID-19 case)

Please enter date of birth for yourself or whoever requires the COVID-19 test.