LPC Staff Contagious Illness Prescreening Questionnaire ({{gravity-field-id-3}})


  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.
  2. The Staff Member indicated above will consent to any Contagious Illness testing recommended by Alberta Health Services while serving at Lone Prairie Camp and for at least 2 weeks afterwards.
  3. The Staff Member indicated above will endeavour to maintain a healthy lifestyle including (but not limited to) healthly sleep habits, drinking plenty of water & maintaining good nutrition.
If you are unable to sign this document because you have symptoms, please email registrar@loneprairiecamp.com as soon as possible. The current AHS recommendation (as of July 1, 2022) is that "If you don’t have a test, or choose not to be tested, you should stay home until your symptoms have improved and you feel well enough to resume normal activities" (see AHS Isolation webpage). Contacting the LPC Office will allow us to have a discussion regarding how best to proceed including whether we require you to test.
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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Document name: LPC Staff Contagious Illness Prescreening Questionnaire ({{gravity-field-id-3}})
lock iconUnique Document ID: 074c1f79fdf8172dde87c45971516eb237529a5e
Timestamp Audit
May 22, 2020 10:26 pm MSTLPC Staff Contagious Illness Prescreening Questionnaire ({{gravity-field-id-3}}) Uploaded by LPC Registrar - registrar@loneprairiecamp.com IP 68.149.136.16
May 22, 2020 10:41 pm MST Document owner info@loneprairiecamp.com has handed over this document to registrar@loneprairiecamp.com 2020-05-22 22:41:13 - 68.149.157.40