Viking Carena Complex Daily Covid Assessment Form
This form must be completed daily prior to entering the Viking Carena Complex Facility.

If an individual answers YES to any of the questions, they must not be allowed to participate in the sport or activity.

Children and youth will need a parent to assist them to complete this screening tool.
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1. Does the person attending the activity, have any of the below symptoms: *
Have you, or anyone in your household, returned from travel outside of Canada in the last14 days? *
Have you or your children attending the program had close unprotected contact(face-to-face contact within two-metres) with someone who is ill with cough and/or fever? *
Have you or anyone in your household been in close unprotected contact in the last 14days with someone who is being investigated or confirmed to be a case of COVID- 19? *
If you have answered "YES" to any of the above questions do not participate. Proceed home and use the AHS OnlineAssessment Tool to determine if testing is recommended.
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