CCC Screening Protocol
Daily Screening Protocol for Campus Children's Centre
Which side does your child(ren) attend? *
Child(ren)'s First and Last Name *
Parent/Guardian's Name *
Email Address *
Primary Symptoms
Please indicate if your child, or anyone in your household, has any of the following symptoms. Please note that if they have ONE of these symptoms, they cannot attend Campus Children's Centre. You should contact your doctor or Manitoba HealthLinks - Info Sante at 204-788-8200 to determine if you should get tested for COVID-19.
Fever of over 38 C? *
Cough *
Sore Throat or Hoarse Voice *
Shortness of Breath / Breathing Difficulties *
Loss of Taste or Smell *
Vomiting or Diarrhea for more than 24 Hours *
Secondary Symptoms: Does anyone in your household have the following symptoms? If TWO or MORE, they cannot attend Campus Children's Centre. *
Required
Any additional comments with regards to symptoms? (ie, if Runny Nose, then 'Clear discharge and no other symptoms')
Have you, or anyone in your household, been in close contact (within 2 metres/6 feet for more than 15 minutes) in the last 14 days with a confirmed case of COVID-19? *
Have you, or anyone in your household, been exposed to COVID-19 in a work or public setting? *
Have you, or anyone in your household, travelled outside of Canada or inside of Canada, east of Terrace Bay, Ontario, within the past 14 days? *
"I declare that I have answered these questions truthfully and to the best of my knowledge." *
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