COVID-19 Screening Form

Please fill out this COVID-19 questionnaire the day of your dinner reservation.

The result is no longer valid if your situation changes during the day (for example, you start experiencing symptoms).

The people with you should also take this screening. You can take it on their behalf if they cannot do it themselves.

Screening Form Submission Valid On September 16, 2021

If public health has advised you that you do not need to self-isolate (for example, you are fully vaccinated or for another reason), select “No.”
If public health has advised you that you do not need to self-isolate (for example, you are fully vaccinated or for another reason), select “No.”
If you are fully vaccinated (it has been 14 or more days since your the final dose of either a two-dose or a one-dose vaccine series), select “No.”
If you are fully vaccinated, select “No.”
If public health has advised you that you do not need to self-isolate (for example, you are fully vaccinated or for another reason), select “No.”
If you have since tested negative on a lab-based PCR test, select "No."
If you are fully vaccinated (it has been 14 or more days since your final dose of either a two-dose or a one-dose vaccine series), select “No.” If you already went for a test and got a negative result, select “No.”