COVID-19 ALBERTA HEALTH DAILY CHECKLIST
This tool has been developed to support us in reducing the risk of transmission of COVID-19 among attendees/staff.
Attendees should complete this checklist prior to participating in the activity or program.
If an individual answers YES to any of the questions, they MUST NOT be allowed to attend or participate in the activity or program.
* Individuals with fever, cough, shortness of breath, runny nose, or sore throat, are required to isolate for 10 days per CMOH Order 05-2020 unless they receive a negative COVID-19 test and are feeling better. Use the AHS Online Assessment Tool to determine if testing is recommended and follow information on isolation requirements.

©2020 Government of Alberta | Updated October 2020     alberta/ca/BizConnect
Sign in to Google to save your progress. Learn more
COVID-19 Alberta Health Daily Checklist
Select your date of entry (form must be completed on every entry) *
MM
/
DD
/
YYYY
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy