Fall 2021 Health Assessment

Please note: Masks are required for everyone over the age of 2. Youth are not required to wear a mask when physically exerting themselves in a program activity.
The information provided on this checklist is collected under the Personal Information and Privacy Act (PIPA) and will be used only for the purpose of providing Alberta Health Services attendee information if a potential exposure occurs onsite. You may complete one form per household/address.