Marcia Murray-Stoof.
Certified Professional Dog Training Instructor
& Canine Behaviourist, with over 25 years experience
I am fully vaccinated against COVID-19 (please complete questions 2-6)
YES
NO
I have tested positive for COVID-19 in the last 90 days (and since been cleared by the local public health unit) (please complete questions 2-6)
Cough or barking cough (croup)
Shortness of breath (croup)
Difficulty breathing
New loss or decrease in sense of taste or smell
Fever and or chills
If adult: unexplained fatigue/ lethargy malaise muscle aches
If child <18 years of age: nausea/vomiting, diarrhea
IF YES YOU ARE NOT PERMITTED TO ATTEND CLASS.
In the last 14 days, have you travelled outside of Canada AND been advised to quarantine (as per the federal quarantine requirements)?
Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)?
In the last 10 days, have you been identified as a “close contact” of someone who currently has COVID-19?
In the last 10 days, have you tested positive on a rapid antigen test or a home-based self-testing kit?
In the last 10 days, have you received a COVID Alert exposure notification on your cell phone?
In the last 14 days, has someone in your household (someone you live with) travelled outside of Canada AND been advised to quarantine (as per the federal quarantine requirements)?
In the last 10 days, has someone in your household (someone you live with) been identified as a “close contact” of someone who currently has COVID-19 AND advised by a doctor, healthcare provider or public health unit to self-isolate?
Is anyone you live with currently experiencing any new COVID-19 symptoms and/or waiting for test results after experiencing symptoms?
If YES to Questions 3-10
YOU ARE NOT PERMITTED TO ATTEND CLASS.
Signed By Email
Date