Download Covid-19 Oath of Illness - Feb 2021 21 1 (1)

Covid-19 Oath of Illness
Karanvir Singh Supal
I, ____________________________________
signed at ____________________
Brampton
print name
city
30
May
2021
this _______
day of ________________,
______,
submit the following
day
month
year
Oath of Illness and swear that the following information is true and complete.
I was unable to attend my test as scheduled with English Testing Canada on
3710 Chesswood Drive
29-May-2021
Toronto, Ontario M3J 2W4
on ______________________
________________________
, because
location
date
initial only next to the items that apply to you
_____
I travelled outside of Canada in the 14-day period prior to my test day,
and I have attached proof of travel.
_____
Local health authorities have asked me to stay in quarantine, and I
have attached the written instructions from the public health unit.
_____
I have been in contact with someone who has Covid-19 in the 14-day
period prior to my test day.
Date of contact:
____________________________________
Type or location of contact: ____________________________________
_____
I am experiencing Covid-like symptoms on or before my test day.
28-May-2021
Date of onset of symptoms: ____________________________________
Type of symptoms:
Fever, Cough, Shortness of Breath
____________________________________
____________________________________
By signing this oath, I swear that the answers I have entered above are truthful.
Hand-Written Signature: ______________________________________________
Covid-19 Oath of Illness 2.1