Crossings COVID Screening Questionnaire
Before attending class or entering the studio, we kindly ask that you complete the following health & safety questionnaire...
Please check the box if you have any of the following symptoms:
Fever (greater than 38.0C)
Shortness of breath/Difficulty breathing
Or ... I feel FIT TO DANCE!
Have, you or anyone in your household travelled outside of Canada in the last 14 days?
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?
Are you currently being investigated as a suspected case of COVID-19?
Have you tested positive for COVID-19 within the last 10 days?
Signature (First & Last Name)
Send me a copy of my responses.
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