COVID-19 Self-Assessment

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All students and tutors are required to complete a self-assessment for COVID-19 symptoms and risk factors before each in-person tutoring session.

If any of the answers are "yes", PLEASE CONTACT STEM TUTORING OTTAWA, the session will be cancelled and reimbursed with respect to the company's COVID-19 Policy.

Email *

Email address *

Student's/Tutor's Name *

Do you have any of the following new or worsening symptoms; fever/chills, cough, difficulty breathing/shortness of breath, sore throat/difficulty swallowing, runny nose, loss of taste or smell, nausea, vomiting, diarrhea, abdominal pain, headache (not related to allergies or other existing medical conditions)? *

Yes

In the last 14 days, have you had close physical contact with a person who; was sick with a respiratory illness, has returned from travel outside of Canada in the last 14 days, or who was a confirmed or probable case of COVID-19? *

Yes

In the last 14 days, have you travelled outside of Canada? *

Yes

Send me a copy of my responses.

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