International Student – Health & Symptom Questionnaire We look forward to welcoming you to the Durham College (DC) Campus. As we navigate the COVID-19 pandemic, our priority remains student and staff health, safety and well-being. As we plan for your arrival, we must implement measures to protect all staff, students and others in line with Canadian Government protocols. When you arrive in Canada, go directly to your place of quarantine without delay and stay there for 14 days. This is mandatory, even if you have no symptoms. You must wear a suitable non-medical mask or face covering while in transit to your quarantine location. You should quarantine longer if you develop signs and symptoms of COVID-19, or have been exposed to another person who has signs and symptoms of COVID-19. Follow Public Health's instructions on how to quarantine. Be aware of the penalties for not following your quarantine plan once you’re in Canada. A fine of up to $750,000 CAD. Six months of jail time in Canada. Being found inadmissible, removed from Canada and banned from entering for one year. Know that you may be contacted by the Ontario government authorities throughout your 14-day quarantine to ensure you're following your plan. The number you may be contacted from is 1-888-336-7735. Monitor yourself for symptoms of COVID-19, including fever/chills, cough, sore throat and shortness of breath. If you have symptoms, reach out to Health Services (519-888-4096) or the local health authorities (1-866-797-0000 in Ontario). Please fill out this questionnaire daily for 14 days and hit submit.What is your name?* First Last What is your email?* What is your Student ID?*How are you feeling today?*I feel fineI feel unwellAre you a close contact of a person who is a confirmed or suspected case of COVID-19 in the past 14 days (i.e. less than 2m for more than 15 minutes accumulative in 1 day)?*YesNoHave you been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days?*YesNoHave you been self-isolating in the location outlined in your quarantine plan?*YesNoDid you arrive with (a) family member(s)?YesNoHow many family member(s) did arrive with you and are isolating with you?Please enter a number from 0 to 50.What is your family member's name?How is he/she feeling today?He/she feels fineHe/she feels unwellAre they a close contact of a person who is a confirmed or suspected case of COVID-19 in the past 14 days (i.e. less than 2m for more than 15 minutes accumulative in 1 day)?YesNoHave they been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days?YesNoHave they been self-isolating in the location outlined in your quarantine plan?YesNoI declare that the information above is accurate*YesNo In accordance with Section 39(2) of the Freedom of Information and Protection of Privacy Act, 1990, the personal information collected on this form is collected under the legal authority of the Ontario Colleges of Applied Arts and Technology Act, 2002 and may be used and/or disclosed for monitoring COVID-19 and quarantine arrangements. Your personal information may also be used for various administrative, statistical and/or research purposes of the College and/or ministries and agencies of the Government of Ontario and the Government of Canada. If you have any questions about the collection, use, and disclosure of your personal information by the College, please contact the Freedom of Information and Protection of Privacy Coordinator, 2000 Simcoe Street North, Oshawa, ON, L1G 0C5, 905.721.2000 ext. 3292.