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STARWARD STORY
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Awards
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Partners
Community
Referral Program
Careers
INNOVATION
Design Studio
COMMUNITIES
COMING SOON
Register Now
For Latest Information
CURRENT COMMUNITIES
The Ridge
River Mill, Cambridge
belle’ ville
Ancaster | Sold Out
Chedoke Heights
Hamilton | Sold Out
Brooklyn Heights 1&2
RiverMill, Cambridge | Sold Out
153 Wilson West
Ancaster | Sold Out
COMPLETED COMMUNITIES
Scenic Trails
Hamilton
Bloom Towns
River Mill, Cambridge
Parkview
River Mill, Cambridge
DESIGN STUDIO
3 Step Process
Meet Your Team
Design Inspiration
Gallery
CUSTOMER CARE
Starward Process and your New Home
Warranty & Tarion
Home Maintenance
FAQ
Customer Care Contact
RESOURCES
Path to Home Ownership
FAQ
Testimonials
Media
Domus Blog
CONTACT
ABOUT
STARWARD STORY
Starward Story
Starward Advantage
Starward Process
COMPANY
Awards
Testimonials
Partners
Community
Referral Program
Careers
INNOVATION
Design Studio
COMMUNITIES
COMING SOON
Register Now
For Latest Information
CURRENT COMMUNITIES
The Ridge
River Mill, Cambridge
belle’ ville
Ancaster | Sold Out
Chedoke Heights
Hamilton | Sold Out
Brooklyn Heights 1&2
RiverMill, Cambridge | Sold Out
153 Wilson West
Ancaster | Sold Out
COMPLETED COMMUNITIES
Scenic Trails
Hamilton
Bloom Towns
River Mill, Cambridge
Parkview
River Mill, Cambridge
DESIGN STUDIO
3 Step Process
Meet Your Team
Design Inspiration
Gallery
CUSTOMER CARE
Starward Process and your New Home
Warranty & Tarion
Home Maintenance
FAQ
Customer Care Contact
RESOURCES
Path to Home Ownership
FAQ
Testimonials
Media
Domus Blog
CONTACT
Chedoke-CovidScreening
Kyle Du Preez
2021-09-15T15:07:27-04:00
COVID-19 Screening Form
First Name
(Required)
Last Name
(Required)
Company / Trade Name
(Required)
How old are you?
(Required)
We collect this anonymous information to ask age-specific questions.
17 years old or younger
18 years old or older
Do any of the following apply to you?
- I am fully vaccinated against COVID-19 (it has been 14 days or more since your final dose of either a two-dose or a one-dose vaccine series)
- I have tested positive for COVID-19 in the last 90 days
(and since been cleared)
Do any of the following apply to you?
(Required)
No
Yes
Are you currently experiencing any of these symptoms?
Choose any/all that are new, worsening, and not related to other known causes or conditions you already have.
Are you currently experiencing any of these symptoms?
Fever and/or chills
Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher
Cough or barking cough (croup)
Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have)
Shortness of breath
Out of breath, unable to breathe deeply (not related to asthma or other known causes or conditions you already have)
Decrease or loss of taste or smell
Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already have
Muscle aches/joint pain
Unusual, long-lasting (not related to getting a COVID-19 vaccine in the last 48 hours, a sudden injury, fibromyalgia, or other known causes or conditions you already have)
Extreme tiredness
Unusual, fatigue, lack of energy (not related to getting a COVID-19 vaccine in the last 48 hours, depression, insomnia, thyroid dysfunction, or other known causes or conditions you already have)
Are you currently experiencing any of these symptoms?
None of the Above
In the last 14 days, have you travelled outside of Canada and been told to quarantine (per the federal quarantine requirements
(Required)
No
Yes
Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?
(Required)
This can be because of an outbreak or contact tracing.
No
Yes
In the last 10 days, have you tested positive on a rapid antigen test or home-based self-testing kit?
(Required)
If you have since tested negative on a lab-based PCR test, select "No."
No
Yes
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