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TRAINING SCREENING
CHECKLIST

TRAINING SCREENING CHECKLIST

To prevent the spread of COVID-19 and reduce the potential risk of exposure to our members, staff, and visitors, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone in this building. Thank you for your time.

Have you had a positive test for COVID-19 within the last 14 days?
Have you returned from any country outside Canada within the last 14 days?
Have you had close contact with, or cared for someone with a respiratory illness, or someone diagnosed with COVID-19 within the last 14 days?
Have you been in close contact with (closer than 6 feet and/or longer than 15 minutes) anyone who has traveled outside Canada within the last 14 days?
Have you experienced any flu-like symptoms in the last 14 days?
  • Cough
  • Shortness of Breath/Difficulty Breathing
  • Fever
  • Sore throat
  • Unexpected fatigue
  • Chills
  • Headache
  • Runny nose/nasal congestion
  • Muscle/body aches
  • Difficulty Swallowing
  • Disorders of taste or sense of smell
  • Nausea/vomiting/diarrhea

If the answer is “yes” to any of the questions, for everyone's safety, you will be required to reschedule your class for another date. You are also advised to follow up with your doctor.

Note: if you plan to be onsite for consecutive days, please immediately advise your instructor if any of your responses change. The information collected on this form will be used to determine your access right to the building.