LPC Contagious Illness Pre-screening Questionnaire ({{gravity-field-id-3}})


The health and safety of Lone Prairie Camp's campers, rental guests and staff is our top priority and we are committed to heeding current provincial and federal government restrictions. As part of those measures, we appreciate you taking the time to complete this Contagious Illness Pre-screening Questionnaire and encourage you to review the information available at the above links.
  1. The Alberta Health Services COVID-19 SELF-ASSESSMENT (https://myhealth.alberta.ca/Journey/COVID-19/Pages/Assessment.aspx) has been truthfully completed today () for and the Alberta Health Services COVID-19 SELF-ASSESSMENT did not recommend self-isolation nor Contagious Illness testing.

It is important that this document is signed by the participant (or their parent/guardian if the participant is under 18 years old) on the day of arrival. Please complete the Alberta Health Services COVID-19 SELF-ASSESSMENT and digitally sign this document before arrival but not before the day of arrival.

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Signature Certificate
Document name: LPC Contagious Illness Pre-screening Questionnaire ({{gravity-field-id-3}})
lock iconUnique Document ID: 0ac8de1b7e832c950c3a00270948be7d44a08516
Timestamp Audit
June 19, 2020 6:33 pm MDTLPC Contagious Illness Pre-screening Questionnaire ({{gravity-field-id-3}}) Uploaded by LPC Registrar - registrar@loneprairiecamp.com IP 68.149.136.16
June 19, 2020 6:46 pm MDT Document owner info@loneprairiecamp.com has handed over this document to registrar@loneprairiecamp.com 2020-06-19 18:46:29 - 69.168.161.253