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Health Declaration

Under Ontario Orange Restrict - Intermediate Measures, screening is required of patrons in accordance with instructions issued by the Office of the Chief Medical Officer of Health.  This information shall only be given to Health officials upon request.

All patrons must fill out this form before being served at Glebe Central Pub. Thank you for your understanding.

Are you experiencing any symptoms of the following; fever and/or chills, cough or barking cough, shortness of breath, sore throat, difficult swallowing, runny or stuffy/congested nose, decrease or loss of taste or smell, pink eye, headache, digestive issues like nausea/vomiting, diarrhea, stomach pain, muscle aches, extrem tiredness, falling down often?
Please read the following? If you check any of the following boxes, kindly vacate and return to your home.
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