Health Check Questionnaire for Youth Events

Name (Required)

Please fill in your first and last name, the person completing the questionnaire.

Subject Name(s) (Required)

Please enter the names of the people you are answering the questions for.

Do the subjects have any symptoms of illness, including fever, cough or sore throat? (Required)

Have the subjects had contact with anyone confirmed positive in the past 14 days? (Required)

Are the subjects living with someone awaiting Covid testing results? (Required)

Have the subjects travelled out of province in the last 14 days? (Required)

Solve 1 + 1 = ?

Portage Avenue Church