Alberta Health Check Please fill out this form before you come to your in-person lesson. Alberta Health Check Name: Are you experiencing any of the following: * Severe difficulty breathing (e.g. struggling to breathe or speaking in single words) Severe chest pain Having a very hard time waking up Feeling confused Fever or chills Cough Difficulty breathing Sore throat Loss of sense of smell or taste Headache Extreme fatigue or tiredness Diarrhea Loss of appetite Nausea or vomiting Body aches None of the above If you are human, leave this field blank. Submit
