COVID Screening Form

This form must be completed within 12 hours prior to visiting Honeybee Yoga Studio. I thank you so much for your understanding during these crazy times! I will update the policy and mask requirements in alignment with provincially mandated regulations as they occur.

Name(required)

I have read and understood the Honeybee Yoga Studio Covid-19 Policy, including the requirement to wear a mask or face covering while travelling from my car to my mat:

Yes, I have read and understand the policy!

Have you travelled outside of Canada in the past 14 days?

Yes No

Have you come into contact with someone who tested positive for COVID-19 in the past 14 days?

Yes No

Have you tested positive for COVID-19 in the past 14 days?

Yes No

Have you experienced any of the following symptoms in the past 14 days – Fever, Chills, New Onset of Cough, Headaches, Worsening Chronic Cough, Unexplained Fatigue/Malaise/Muscle Aches (myalgais), Shortness of Breath, Nausea/Vomiting, Diarrhea, Abdominal Pain, Difficulty Breathing, Pink Eye (Conjunctivitis), Sore Throat, Runny Nose or Nasal Congestion (without other known cause), Difficulty Swallowing and/ or Decrease or Loss of Sense of Taste or Smell:

Yes No

By submitting your information, you are agreeing to comply with the Honeybee Yoga Studio COVID-19 Policy.

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