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NHBT





I already filled out the form at check-in but wish to record my check-out time. ONLY YOUR EMAIL IS STILL REQUIRED.
You may be asked to record extra information. Ie. Table number, floor or department visited, etc.
18 or older
under 18
  • Fever and/or chills
    • Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher
  • Cough or barking cough (croup)
    • Not related to asthma, post-infectious reactive airways, COPD, or other known causes or conditions you already have
  • Shortness of breath
    • Not related to asthma or other known causes or conditions you already have
  • Decrease or loss of smell or taste
    • Not related to seasonal allergies, neurological disorders, or other known causes or conditions you already have
  • (For adults ≥ 18 years or older)
    Fatigue. lethargy, malaise and/or myalgias
    • Unusual tiredness, lack of energy (not related to depression, insomnia, thyroid dysfunction, or other known causes or conditions you already have)

      If you received a COVID-19 vaccination in the last 48 hours and are experiencing mild fatigue that only began after vaccination, select "No".
  • (For children < 18 years)
    Nausea, vomiting and/or diarrhea
    • Not related to irritable bowel syndrome, anxiety, menstrual cramps, or other known causes or conditions you already have
This can be because of an outbreak or contact tracing.
If public health has advised you that you do not need to self-isolate (e.g., you are fully immunized* or have tested positive for COVID-19 in the last 90 days and since been cleared), select “No.”

* A fully immunized individual is defined as any individual >14 days after receiving their second dose of a two-dose COVID-19 vaccine series or their first dose of a one-dose COVID-19 vaccine series (i.e., Johnson and Johnson).
If you are have already gone for a test and got a negative result, select "No." If you are fully immunized or have tested positive for COVID-19 in the last 90 days and since been cleared, select "No."
If you have since tested negative on a lab-based PCR test, select “No.”
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 you are fully immunized or have tested positive for COVID-19 in the last 90 days and since been cleared, select “No.”