COVID-19 Survey

Dr. Alice Wong and Panda Pediatrics
4825 Dalhousie Drive NW403-239-9333

Symptoms Check

I have experienced symptoms of COVID-19 in the past 14 days. Symptoms of COVID-19 include, but are not limited to:

  • Fever or chills
  • Cough
  • Shortness of breath
  • Difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea


I have tested positive for COVID-19 in the past 14 days or I am currently waiting on the results of a COVID-19 test.


I have knowingly been in close or proximate contact in the past 14 days with someone who has tested positive for COVID-19 or has or had symptoms of COVID-19.

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