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COVID-19 Screening Questionaire

The purpose of this questionnaire is to take preventative measures to ensure the health and safety of all Municipality of Kincardine residents. Please fill out this form before entering the building. 

Fever and/or chills 

Shortness of breath 

Cough or barking cough (croup)

Extreme tiredness

Muscle aches/joint pain 

Decrease or loss of taste or smell



Personal information is collected under the authority of the Municipal Act, for the purpose of creating a record to be used for contact tracing for people who enter Municipal facilities. Questions about the collection of the personal information may be addressed to the Clerk of the Municipality of Kincardine, 1475 Concession 5, R.R. 5, Kincardine, Ontario N2Z 2X6. Phone: 519-396-3468