You must immediately self-isolate. You may need to be tested for COVID-19.

You must self-isolate until you receive further instruction.

Do not visit a hospital, physician’s office, lab or healthcare facility without consulting Health Link (811) first.
Don't go to any public places.
Stay at home, and don’t have any visitors.
Don’t share personal items like dishes, utensils, or towels.
Wash your hands often.
Avoid close contact with other people, especially those with chronic conditions, a compromised immune system, or seniors (over 65 years of age).

If your symptoms worsen, call 811. We are experiencing heavy call volumes and will get to your call as quickly as we can.

Call 911 if you are seriously ill and need immediate medical attention. Inform them that you may have COVID-19.

Please provide your contact information and healthcare number below. You will be contacted to confirm your symptoms and discuss next steps which may include a referral for testing.

First Name*

Last Name*

City or Town you currently reside in*

Phone Number*

Alberta Healthcare Number

Date of Birth*

AHS is a custodian with the authority to collect, use and disclose identifying health information, including healthcare numbers, under the Health Information Act. AHS is collecting and will use the information you provide in case we need to contact you to follow up about your health status. By submitting this form, you are acknowledging that you have been made aware of the purpose for which AHS will use and disclose your health information and authorizing its use and disclosure for this purpose. If you have questions about AHS’ authority or practices in relation to health information, please contact the Disclosure Help Line at 1.855.312.2265 or by email disclosure@ahs.ca. Alternatively, you can email privacy@ahs.ca.

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You must immediately self-isolate. You may need to be tested for COVID-19.

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