Student screenning Check

    Hanul Art School Student
    COVID-19 SCREENING CHECK
    LIST

    Does the person attending the activity, have any of the below symptoms (Q1 - Q14): YES / NO
    Q1 Fever YESNO
    Q2 Cough YESNO
    Q3 Shortness of Breath/Difficulty Breathing YESNO
    Q4 Sore Throat YESNO
    Q5 Chills YESNO
    Q6 Painful Swallowing YESNO
    Q7 Runny Nose/Nasal Congestion YESNO
    Q8 Feeling Unwell/Fatigued YESNO
    Q9 Nausea/Vomiting/Diarrhea YESNO
    Q10 Unexplained loss of appetite YESNO
    Q11 Loss of sense of taste or smell YESNO
    Q12 Muscle/Joint Aches YESNO
    Q13 Headache YESNO
    Q14 Conjunctivitis YESNO
    Q15. Have you, or anyone in your household, travelled outside of Canada in the last 14 days? YESNO
    Q16. Have you or your children attending the program had close unprotected* contact (face-to-face contact within 2 metres/6 feet) with someone who is ill with cough and/or fever? YESNO
    Q17. Have you or anyone in your household been in close unprotected contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19? YESNO
    Q18. Have you had your school or AHS contact you to self isolate within a week? YESNO

    If you have answered “YES” to any of the above questions do not participate in-Person Class.

    In addition, my child and I have read and reviewed Hanul Art School’s Covid-19 Procedural Guide and Protocols provided to me over this form and through Hanul Art School’s website at www.hanulartschool.com. My child and I will do the COVID-19 screening check list before attend the Hanul Art School.

    I confirm that I have read and fully understand the guidelines regarding the Screening Checklist above as well as the Hanul Art School Covid-19 Procedural Guide and Protocols and will abide by the policies listed.

    Student Information

    First Name:

    Last Name:


    Theme: Overlay by Kaira Hanul Art School 2010. All right reserved.
    228 91St, Edmonton, AB, T6X 1W8