This survey is for Western Health Staff, Students and Volunteers only

Please complete this survey if you are COVID-19 positive.

Ensure ALL relevant fields are completed. You will have the opportunity to ask specific questions at the end of the survey.

You must click 'Submit' at the end of each page.

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To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.