Daily Health Check SD73 – School Safety Association of BC

Date*
Date Format: MM slash DD slash YYYY
Location*
Your Name*
First Last
Administrator/Manager Email*
Environmental COVID-19 check*
- I confirm that I have not travelled outside of Canada in the past 14 days, been identified by Public Health as a close contact of someone with COVID-19 or been told to self-isolate by Public Health
- One or more of these situations apply to me
Daily Health Check*
Refer to the list of common COVID-19 symptoms
- I confirm that I do not have any new or worsening symptoms of COVID- 19
- I have one or more new or worsening symptoms of COVID-19