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Please fill out the form below to self-screen for COVID-19.

If you answer “Yes” to any of the below questions, do not enter Glen Martin Limited; instead, please contact us via phone.

Common Symptoms List:

  • Fever Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher
  • Chills
  • Cough that’s new or worsening
  • Barking cough, making a whistling noise when breathing
  • Shortness of breath, out of breath, unable to breathe deeply
  • Sore throat
  • Difficult or painful swallowing
  • Runny nose
  • Stuffy or congested nose
  • Decrease or loss of taste or smell
  • Pink eye or conjunctivitis
  • Headache that’s unusual or long lasting
  • Digestive issues like nausea/vomiting, diarrhea, stomach pain
  • Muscle aches that are unusual or long lasting
  • Extreme, unusual tiredness or fatigue
  • Sluggishness or lack of appetite


  • Symptoms above (excluding fever) that are related to other known minor causes or conditions (such as asthma, allergies, or fatigue)

    1. Do you have any of the symptoms listed in the above common symptoms list?*

    2. Have you traveled outside Canada in the last 14 days?*

    3. Have you had an exposure with a confirmed COVID-19 patient in the past 14 days?*

    If you answered "Yes" to any of the above questions, you cannot submit this form.
    Please do not enter Glen Martin Limited.

    First Name*

    Last Name*

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