Lakecrest Online Screening Form

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Prior to entering Lakecrest, ALL visitors are asked to complete this form to confirm you are symptom-free, are safe to enter our campus, and have adhered to all Provincial and Federal guidelines. Failure to complete this form will prevent you from entering the premises.

Please ensure you click the SUBMIT button after completing all sections of the form.

What is the name of the person entering Lakecrest? *

For contact tracing purposes, please record your phone number. *

What is the date you are entering Lakecrest? *

YYYY

Do you confirm you are symptom-free, and are not currently required to self-isolate due to a positive test result or a provincial/federal travel restriction?
*

Yes

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