COVID-19 Assessment
It is mandatory that everyone who enters the Vancouver Mind-Body Centre studio complete this screening PRIOR to entering the space. This checklist may be updated as the situation progresses over the next weeks and months.

Please fill out this form on the DAY of each class, at least 1 hour before EACH class. The submission time will be noted and your instructor will confirm your submission before training.
Email *
Full name *
Date of class *
MM
/
DD
/
YYYY
Time of class *
Time
:
Name of class
Clear selection
Are you Experiencing any of these symptoms? *
Required
Have you or someone in your household travelled outside of Canada in the last 14 days? *
Have you, or has anyone in your household been in contact in the last 14 days with someone who is being investigated or who has a confirmed case of COVID-19? *
Are you currently being investigated as a suspect case of COVID-19? *
Have you tested positive for COVID-19 within the last 10 days? *
Submit
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