TSO Health Attestation Form 2021
The following questions must be answered by each individual/parent prior to entry to the Music School, rehearsal, group sessions, or any other activity under the stewardship of the Timmins Symphony Orchestra, Geoffrey James Lee School of Music
.
The answers to all questions must be “NO” in order to attend lessons or rehearsal, et al. To protect your data, all information collected will be kept private and confidential.

Do you have any of the following symptoms?

1. Do you currently have one or more of the COVID-19 symptoms below that are new or worsening?
fever and/or chills
cough or barking cough (croup)
shortness of breath
decrease or loss of smell or taste
fatigue and/or malaise (for adults)
nausea/vomiting, and/or diarrhea (for <18 years of age)
Symptoms should not be chronic or related to other known causes or conditions.

2. Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?

3. Do you live with someone who has been told by a doctor, health care provider, or public health unit that they should currently be isolating? (If you are fully immunized*or have tested positive for COVID-19 in the last 90 days and since been cleared*, select “No.”)

If you answer YES to any one of the questions above, PLEASE DO NOT enter the location AND contact either your health care provider or Telehealth Ontario (1-866-797-0000) to get advice or an assessment, including if you need a COVID-19 test.

Porcupine Health Unit
Telephone: 705.360.4819
Assessment Centres
The COVID-19 Assessment Centres are clinics where people are assessed by a healthcare provider and tested for COVID-19 if required. Call your local Assessment Centre directly to book an appointment.
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