Please complete all fields
[CLOSE]
[CLOSE]
KCFSC Session Tracking and COVID Questionnaire

There are no open sessions

Session Name Here

First Name
Last Name
Phone
User
Location

Do any of the following apply to you?

1. Do you have a fever (a temp of 37.8C or higher)?
2. Do you have any of the following symptoms which are new or worsened if associated with allergies, chronic or pre-existing conditions: cough, shortness of breath, sore throat, difficulty swallowing, loss of taste or smell, runny nose, sneezing or nasal congestion?
3. Have you or someone in your household travelled outside of Canada or had close contact with anyone that has travelled outside of Canada in the past 14 days?
4. Have you had close contact in the past 14 days with anyone with a new cough, fever or difficulty breathing or a confirmed case of COVID-19?
5. In the past 14 days have you been directed by Public Health to self-isolate?
6. I will NOT be attending this session.

Your Answer

  Submit
  Cancel