Class Sign-in

In consideration of the risks of COVID-19, we are conducting active screening for potential risks of COVID-19, along with daily attendance for contact tracing. Please submit this form daily before class, This on-line form will provide  with all students to ensure everyone's safety and well being. Please review the following questions. If the answer to any of them is yes, please identify at the end of the survey. 

 

1) Do you have any of the following symptoms: 

        • Fever over 38.0 C (100.4 F) 

        • New, unexplained or worsening acute respiratory illness symptom (e.g. cough, difficulty breathing, nasal congestion) 

        • New, unexplained or worsening nausea/vomiting, diarrhea, abdominal pain 

        • New, unexplained or worsening fatigue, headache, chills 

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2) Have you returned to Canada from outside the country (including the USA) within the last 14 days? 

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3) Have you had close contact with a confirmed or probable COVID-19 case? 

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4) Have you had close contact with a person with acute respiratory illness who has been outside Canada in the last 14 days? ​

 

5) Have you received public health or medical advice to self-monitor or self-isolate? 

I have reviewed the preceding questions.

If you answered TRUE, please provide details below