Covid-19 Daily Health Check List
This form is for Covid tracking only and will be deleted 14 days after your visit to the facility.
This form is based on:
COVID-19 INFORMATION
COVID-19 ALBERTA HEALTH DAILY CHECKLIST
alberta.ca/BizConnect
Email: BizConnect@gov.ab.ca
©2020 Government of Alberta | Updated: June 22, 2020
Overview
This tool has been developed to support activity organizers and facility operators in reducing the risk of transmission of COVID-19 among attendees. The tool is meant to be used to assist with assessing attendees who may be symptomatic, or who may have been exposed to someone who is ill or has confirmed COVID-19.
Attendees should fill out this checklist prior to participating in the activity or program. If an individual answers YES to any of the questions, they must not be allowed to attend or participate in the activity or program. Children and youth will need a parent to assist them to complete this screening tool.
As the COVID-19 pandemic continues to evolve, this screening tool will be updated as required.
Initial Screening Questions
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Email *
Please Type your name in full *
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