Patient Assessment Email* Have you tested positive for COVID-19 in the past 14 days?*YesNoDo you have any of the following symptoms that are new or worse than usual?* Fever (37.8C or greater), New cough, Shortness of breath, Sore throat, Runny nose or sneezing, Nasal congestion, Hoarse voice, Difficulty swallowing, Unexplained fatigue, Digestive symptoms (including nausea, vomiting, diarrhea, abdominal pain), Chills, Headache, Loss of taste/smell or eye infection.YesNoHave you spoken to a health care provider or been assessed/tested to rule out COVID-19?*YesNoHave you developed any additional symptoms since that time?*YesNoHave you returned from travel outside of Canada in the past 14 days?*YesNoHave you been in close contact (within 2 meters for 5 min or longer) with a confirmed case of COVID either at work or at home without personal protective equipment within the past 14 days?*YesNoDeclaration I declare that the information shared is true to the best of my knowledge. Please proceed with your scheduled appointment.Patient* I am a patient at the Ottawa Fertility Centre.