COVID-19 Self-Assessment Tool & Declaration of Health

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This self-assessment tool, developed with the BC Ministry of Health, will help determine whether you may need further assessment for COVID-19 testing by a healthcare provider or at a local collection centre. You can complete this assessment for yourself, or on behalf of someone else.

Note that this self-assessment tool is intended for COVID-19 only. Your symptoms may not be related to COVID-19 and could require you to seek medical attention. If you are uncertain and/or feel very sick, contact your family doctor/nurse practitioner or call 8-1-1.

Once you have completed this self-assessment tool and are clear of any COVID-19 symptoms you will able to sign our online waiver and clear to participant in any MSAA Course or Tour.

Email *

PLEASE NOTE: Filling out this Declaration of Health for yourself and those participating in your group booking attests that to the best of your knowledge, the statements made are accurate and true. *

I agree that the following statements are accurate and true.

Required

Please provide your Order Number (you can find this in your confirmation email) *

Are you filling this out for yourself or on behalf of someone else? *

Myself

My whole group

Other:

Are you (or anyone in your group) experiencing any of the following:

• Severe difficulty breathing (e.g. struggling to breathe or speaking in single words)
• Severe chest pain
• Having a very hard time waking up
• Feeling confused
• Losing consciousness

Yes

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