Simcoe Contemporary Dancers COVID-19 Pre-Screening Questionnaire

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Please complete this form prior to attending any live events with Simcoe Contemporary Dancers. Thank you!

Please provide your contact information including name, phone number, and email address *

Have you traveled outside of Canada within the last 14 days and/or been asked to quarantine within the last 14 days? *

Yes

Have you been in close contact with anyone who has traveled outside of Canada in the last 14 days? *

Yes

Have you tested positive for COVID-19 and/or had close contact with a confirmed case of COVID-19 in the last 14 days? *

Yes

Have you experienced any cold or flu-like symptoms within the last 14 days? *

Yes

I confirm the information I've provided above is accurate *

I do

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