COVID-19 SCREENING FOR CPS PROGRAM

Please fill out the following health declaration form in order to participate in our activity. Submissions are only valid the day of your visit.
Are you/the person attending the CPS program presenting with a Fever?
Are you/the person attending the CPS Program experiencing a new or worsening cough?
Have you/the person attending the CPS Program have close contact with acute respiratory illness?
Do you/the person attending the CPS program have a confirmed case of Covid-19, or had close contact with a confirmed case of Covid-19?

Thanks for submitting!