LC Camp Daily Health Check

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Covid - 19 Daily Health Check

First Name *

Last Name *

Date *

YYYY

Do you have any of the following new or worsening symptoms or signs?

Symptoms should not be chronic or related to other known causes or conditions.

Fever or chills *

Yes

Difficulty breathing or shortness of breath *

Yes

Cough *

Yes

Loss of smell or taste *

Yes

Sore throat, trouble swallowing *

Yes

Runny nose/stuffy nose or nasal congestion *

Yes

Loss of appetite *

Yes

Nausea, vomiting, diarrhea, abdominal pain *

Yes

Not feeling well, extreme tiredness, sore muscles *

Yes

In the past 14 days have you?

Travelled outside of Canada? *

Yes

Had close contact with a confirmed case of covid 19? *

Yes

If you answered NO to all of the above questions you may enter the workplace

If you answered YES to any of the above questions you may not enter and must report your results to Stacy at 604-856-0892 and leave the workplace, minimizing contact with any other youth.

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