Daily Log Sheet for Instructors and Students
Covid-19 Self Assessment: Have you tested positive for COVID-19 or had close contact with a confirmed case of COVID-19 in the last 14 days?
Are you experiencing any of the following symptoms?
· New onset of cough
· Worsening chronic cough
· Shortness of breath
· Difficulty breathing
· Sore throat
· Difficulty swallowing
· Decrease of loss of sense of taste or smell
· Unexplained fatigue/malaise/muscle aches (myalgias)
· Nausea/vomiting, diarrhea, abdominal pain
· Pink eye (conjunctivitis)
· Runny nose or nasal congestion without other known cause
· Have you travelled outside of Canada in the last 14 days?
If answered yes to any of the above questions, please take the appropriate measures outlined by Health Canada.
I attest that the information provided is correct and accurate:
Student's Signature: _______________
Instructor's Signature: _____________
Note : One Instructor and One Student will be in the car for training.
Bring a face covering mask to wear inside the car.
Sanitize your hands before entering the car (bring your own sanitizer if you would like)
Undergo temperature checks before entering the car.
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