COVID-19, Sign IN

Please complete the form below and a Chuck’s Roadhouse Bar and Grill representative will get back to you.

    If you answer yes to any of the following questions please do not enter the premises, return home and contact your local public health unit for further direction. Do you have any new or worsening of the following symptoms (that are not chronic or related to other known causes or conditions)?

    • Fever and/or Chills (temperature of 37.8°C/100.0°F or greater)
    • Headache that is unusual or long lasting
    • Cough or barking cough
    • Difficulty breathing / shortness of breath
    • Sore throat/trouble swallowing
    • Runny or stuffy / congested nose
    • Loss or decrease of taste or smell
    • Not feeling well
    • Unexplained fatigue/muscle aches
    • Pink Eye
    • Nausea/vomiting/diarrhea
    • Falling down often
    • Have you been in close contact with someone who has tested positive or a probable case of COVID-19 in the past 14 days?
    • Is anyone in your household currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?
    • Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?
    • Has Public Health or the COVID-19 app notified you as being exposed to COVID-19 and required you self isolate?
    • Have you or anyone in your household returned from travel outside of Canada in the past 14 days?
    • Does anyone in your dining party live outside of your residence or are not an essential worker (i.e. personal support worker)?

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