HCA Covid-19 Pre-Entry Survey
All students and staff members must complete a pre-screening survey online each time prior to entering the building. Students will not be permitted to participate in group or private lessons until a parent/guardian has successfully completed the survey.

Please note: It must be completed the DAY OF each class to be valid.
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Last Name* *
First Name *
In the last 5 days does the student/staff member, or anyone in your household, have any of the following symptoms? *
Does the student/staff member have any of the following symptoms? *
In the last 14 days have you travelled outside of Canada and were told to quarantine or told to not attend school/child care or someone you live with returned from outside Canada and is isolating while waiting for COVID-19 test results? *
Have you been identified as a “close contact” of someone who currently has COVID-19 and been advised to self-isolate? *
Are you or any member of your household awaiting the results of a COVID-19 test? *
Do you live with someone who is currently isolating because of COVID-19 symptoms or a positive COVID-19 test? *
In the last 5 days, have you tested positive for COVID-19? Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? *
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