Queen Elizabeth Public Completed Daily COVID-19 Screening Questions

Child's Name:

Is the student/child currently experiencing any of these symptoms?
The symptoms listed here are the symptoms most commonly associated with COVID-19. Our guidelines for children and adults continue to evolve as we learn more about COVID-19, how it spreads, and how it affects people in different ways.
Choose any / all that are new, worsening, and not related to other known causes or conditions they already have.

Temperature of 37.8 degrees Celsius / 100 Degrees Fahrenheit or higher and / or chills

Continuous, more than usual, making a whistling noise when breathing (not related to asthma, post-infectious reactive airways, or other known causes or conditions they already have)

Out of breath, unable to breathe deeply (not related to asthma or other known causes or conditions they already have)

Not related to seasonal allergies, neurological disorders, or other known causes or conditions they already have

Not related to irritable bowel syndrome, anxiety, menstrual cramps, or other known causes or conditions they already have

If YES, skip questions 3, 4, 5,

If the individual experiencing symptoms received a COVID-19 vaccination in the last 48 hours and is experiencing mild fatigue, muscle aches, and / or joint pain that only began after vaccination, select "NO".

If public health has advised you that you do not need to self-isolate, select "NO."

If they already went for a test and got a negative result, select "No".

If travel was solely due to a cross boarder custody arrangement, select "No".

This can be because of an outbreak or contact tracing.

If the student / child has since tested negative on a lab-based PCR test, select "No".

Results of Screening Questions
If you answered "YES" to any questions in DO NOT go to school or childcare.
If you answered "NO" to all questions, your child may go to school or childcare because they seem to be healthy and have not been exposed to COVID-19
Public Health Ontario - Contact Tracing
Person Completing this Form:

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Main Office

46 Division Rd. N
Kingsville, ON

P: 519-733-8202 | F: 519-733-2988

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Jack Miner
Public School

79 Road 3 East, R.R. #2
Kingsville, ON N9Y 2E4

P: 519-733-8875

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Public School

36 Water Street Kingsville,
ON N9Y 1C9

P: 519-733-0105

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St. John De Brebeuf
Catholic School

43 Spruce Street
Kingsville, ON

P: 519-733-6203

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Queen Elizabeth
Public School

4 Maxon Street Leamington,
ON N8H 2E2

P: 519-322-5532

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Gosfield North
Public School

302 County Road 27 Cottam,
ON N0R 1B0

P: 519-839-4646

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