COVID-19 Screening Checklist
Please fill out the below screening prior to entry at Playtopia. If you have answered yes to any of the below questions, PLEASE DO NOT ENTER PLAYTOPIA. Please call us if you have answered yes to any of the below questions and we will assess the situation and give next steps. This will also serve as a form of contact tracing, which is why your phone number is required.
Email *
Name of Guest(s) *
Phone Number *
Date today *
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In the last 14 days, has the student/child travelled outside of Canada? *
Has a doctor, health care provider, or public health unit told you that the student/child should currently be isolating (staying at home)? *
In the last 14 days, has anyone on this form been identified as a “close contact” of someone who currently has COVID-19? *
Is anyone on this form currently experiencing fever and/or chills? (temperature of 37.8 degrees Celsius or higher) *
Is anyone on this form currently experiencing cough or barking cough (croup)? *
Is anyone on this form currently experiencing shortness of breath? *
Is anyone on this form currently experiencing decrease or loss of taste or smell? *
Is anyone on this form currently experiencing sore throat or difficulty swallowing? *
Is anyone on this form currently experiencing runny or stuffy/congested nose? *
Is anyone on this form currently experiencing headache? *
Is anyone on this form currently experiencing nausea, vomiting and/or diarrhea? *
Is someone that anyone on this form lives with, currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms? *
If you answered “NO” to all questions, you and those listed on this form may enter Playtopia because they seem to be healthy and have not been exposed to COVID-19. Thank you for doing your entry screening! *
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