Student & Visitor Wellness Check

1. In the last 5 days have you or your dancer experienced any of the below symptoms?

List of Symptoms:
Fever
Cough or barking cough
Shortness of breath
Difficulty breathing
Sore throat, trouble swallowing
Runny or stuffy nose
Headache
Extreme tiredness
Muscle aches or joint pain
Nausea, vomiting or diarrhea
Decrease or loss of taste or smell
Not feeling well, tired or sore muscles

2. In the last 5 to 10 days have you tested positive for COVID-19?

3. Do you live with someone who is isolating because of a positive COVID-19 test, symptoms of COVID-19 or is awaiting COVID-19 test results?

4. Have you or anyone in your household travelled outside of the country in the 14 days prior to class and have been advised to quarantine as per government quarantine requirements?

5. Have you been identified as a "close contact" of someone who currently has COVID-19 and have been advised to self-isolate?


*If you answered YES to any of these questions, stay home and self-isolate right away. Call Telehealth or your health care provider to find out if you need a test. Students can access their classes digitally through Zoom if unable to attend in person.
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Family Name (Please use the name listed on your Jackrabbit Portal) *
Name of Dancer or Visitor *
Date *
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Please confirm that you have completed the Wellness Check using the questions above and you are safe to enter the Pegasus Dance Studios Building. *
Required
Please confirm that you have read our Safer Studio Policies. http://www.pegasusstudios.com/policies-434665.html *
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