Crossings COVID Screening Questionnaire
Before attending class or entering the studio, we kindly ask that you complete the following health & safety questionnaire...
Email address *
Please check the box if you have any of the following symptoms: *
Have, you or anyone in your household travelled outside of Canada in the last 14 days? *
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Have you, or anyone in your household been in contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19? *
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Are you currently being investigated as a suspected case of COVID-19? *
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Have you tested positive for COVID-19 within the last 10 days? *
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Date completed *
Signature (First & Last Name) *
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