Daily Screening For ABA Participation
This form is time stamped and must be completed every attendance at an ABA session, before the participant enters the facility.
Person conducting the screening (Parent, Participant, or Staff Name)
Have you been in close contact with someone who is sick or has confirmed COVID-19 in the past 14 days?
Have you returned from travel outside of Canada in the past 14 days?
Are you experiencing any of the following symptoms of Covid-19:
Fever (temperature of 37.8°C / 100.4°F or greater in the last 24 hours)
New or worsening cough
Shortness of breath or any trouble breathing (dyspnea)
Sore throat and/or difficulty swallowing
Runny nose, or nasal congestion
Nausea/vomiting, diarrhea, abdominal pain
Loss of any ability to taste or smell
Experiencing headaches or feeling at all unwell
Unexplained fatigue / malaise /myalgia
None of the above
Please complete the screening by checking the appropriate box:
Participant has no symptoms of Covid-19 and will be attending ABA's session today.
Participant is experiencing symptoms of Covid-19 and will not be attending ABA's session today.
Participant has no symptoms of Covid-19 but will be staying home today.
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