DanceTones Studios COVID-19 Questionnaire
Please answer the questions in the following questionnaire. One form must be completed per student. If the student is under 18 years of age, a parent/guardian must complete the form on the student's behalf. Thank you for helping us return to dancing safely.
Student Name
Age of Student
Clear selection
Contact Number. If under 18 years of age, please provide the parent/guardian's name and contact number.
Please select if you have or had any of the following symptoms in the past 14 days.
Have you been diagnosed with suspected COVID-19 infection in the past 14 days?
Have you been diagnosed with confirmed COVID -19 infection in the past 14 days
Are you a close contact of a person who is a confirmed or suspected case of COVID-19 in the past 14 days?
Have you travelled outside of Ireland in the past 14 days?
If you have travelled outside of Ireland in the past 14 days, please state the location.
Please provide details of any other circumstances relating to COVID-19 not included in the above questions that you would like to disclose.
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