Symptom Check: Over 18 years
This health screen should be filled out by adult dancers before EVERY in-person private lesson. This checklist applies to dancers ages 18years and older. Dancers attending academic Grade 12 must fill out the 18years and under screen.

**Please complete this form no earlier than 4 hours before your scheduled lesson. (note: once the form is submitted it is auto-stamped with the date and time).

If you answer YES to any of the questions, please contact the studio to arrange to attend class virtually. If you have a private lesson scheduled, please contact the studio to re-book your lesson. There is no financial penalty to re-book a private lesson.
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Dancer's Full Name (First and Last) *
If you have traveled outside of Canada in the last 14 days, follow the Government of Canada Travel, Testing, Quarantine and Borders instructions available here: https://travel.gc.ca/travel-covid *
Do you have any new onset (or worsening) of any of the following symptoms: fever, cough, shortness of breath, runny nose, sore throat, chills, painful swallowing, nasal congestion, feeling unwell/fatigued, nausea/vomiting/diarrhea, unexplained loss of appetite, loss of sense of taste or smell, muscle/joint aches, headache, conjunctivitis (pink eye)? *
Required
If you have answered YES to any of the above questions do not participate in class today. Proceed home and use the AHS Online Health Assessment Tool to determine if testing is recommended.  https://myhealth.alberta.ca/Journey/COVID-19/Pages/COVID-Self-Assessment.aspx
https://myhealth.alberta.ca/Journey/COVID-19/Pages/COVID-Self-Assessment.aspx 
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