top of page

COVID-19 Screening Survey

Thank you for booking a session with us. Muskoka Wake strives to provide optimal health and safety conditions for our community. In order to maintain these conditions amidst ongoing concerns of COVID-19, we appreciate your cooperation in completing the following survey prior to your session.

​

Please complete a separate survey for each participant.

 

If you have booked multiple sessions throughout the summer, please submit a new survey prior to each booking. 

 

Thank you very much for your cooperation and understanding. 

 

- Muskoka Wake  

I am a/I am filling this form on behalf of a
Is the participant/staff member experiencing any of the following symptoms?

Fever (>37.8 C), Chills, cough that's NEW or worsening, barking cough (making squeaky or whistling noise when breathing) (croup), shortness of breath (out of breath, unable to breathe deeply), sore throat, difficulty swallowing, hoarse voice (more rough or harsh than normal), runny nose, stuffy or congested nose, lost sense of taste or smell, headache, digestive issues (nausea/vomiting, diarrhea,

stomach pain), fatigue (lack of energy, tiredness), falling down more than usual, for young children: sluggishness or lack of appetite

Please click any that apply:
Has the participant/staff member travelled outside of Ontario in the past 14 days?

Thanks for submitting!

bottom of page