Pre-Screening Wellness Check
This is required every time you visit Groove Barre. For the safety of our staff and other clients, please answer the following questions honestly:
What is your name? *
When is your visit to Groove Barre (please complete within a 24 hour window of your visit) *
Are you currently experiencing any of these symptoms? Click to choose yes for any/all that are new, worsening, and not related to other known causes or conditions you already have. If yes for any symptoms, please DO NOT visit the studio until you have been cleared by public health. You should be tested for COVID-19 and follow the advice of public health. *
Required
In the last 14 days, have you been identified as a "close contact" of someone who currently has COVID-19? If yes, please DO NOT visit the studio until you have been cleared by public health. *
Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms? If yes, please DO NOT visit the studio until you are cleared by public health or public health guidelines. *
In the last 14 days, have you or anyone you live with travelled outside of Canada? If yes, please DO NOT visit the studio until you are cleared by public health or public health guidelines. *
Have you been diagnosed with COVID-19 in the last 30 days? If yes, please DO NOT visit the studio until you are cleared by public health. *
If you answered YES to any of the questions above, please verify you have been cleared by either public health or public health guidelines to visit the studio.
Clear selection
By checking this box, I acknowledge, know and understand that although all best efforts to clean and sanitize are made by Groove Barre, the risk of contracting an illness, including but not limited to COVID-19, exists. I understand the risks and freely and voluntarily accept and assume all such risks, and take full responsibility for my own actions, safety and welfare, and accept that Groove Barre does not take responsibility if I contract any such illness. *
Required
By checking this box, I acknowledge that I do not have any medical condition(s), including but not limited to symptoms or a diagnosis of COVID-19, that would result in illness to the Client or anyone else, as a result of the my attendance to the premises of Groove Barre. If I am aware of any such medical condition(s) or symptoms, it will be my sole responsibility to abstain from attending any appointments made at the premises of Groove Barre. *
Required
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