Stabback Music Studio

Music washes away from the soul the dust of everyday life.

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Screening for in-person lessons

Students must complete the self screening tool before arriving onsite for each lesson.

If you are sick, or displaying symptoms of COVID-19, please stay home and request an online lesson.

Please note: parents and students are required to wear a mask while in the building.

First name of student. *

Last name of student. *

First name of parent/guardian. *

Last name of parent/guardian. *

Does the student have 1 or more of these new or worsening symptoms, today or in the last 5 or 10 days: fever (37.8 or higher) and/or chills, cough that is new or worsening, shortness of breath, or decrease or loss of taste or smell*? *

Yes
No

Does the student have 2 or more of these new or worsening symptoms, today or in the last 5 or 10 days: sore throat or difficulty swallowing, runny or stuffy nose, headache (unusal or long lasting), extreme tiredness or lack of energy, muscles aches or joint pain, nausea, vomiting, and/or diarrhea? *

Yes
No

Are any close contacts of the student currently experiencing any symptoms of COVID-19 that are new, worsening, and not related to other known causes or conditions? *

Yes
No

Is the student, or any close contacts of the student, waiting for PCR tests results after experiencing COVID-19 symptoms? *

Yes
No

Has a doctor, healthcare provider, or public health unit told the student, or any close contacts of the student, that they should currently be isolating (staying at home)? *

Yes
No

In the last 10 days, has the student, or any close contacts of the student, tested positive on a PCR test, a rapid antigen test, or a home-based self-testing kit? *

Yes
No

In the last 10 days, has the student, or any close contact of the student, been identified as a “close contact” of someone who currently has COVID-19? *

Yes
No

In the last 10 days, has the student, or any close contacts of the student, received a COVID Alert exposure notification on their cell phone? *

Yes
No

In the last 14 days, has the student, or any close contacts of the student, travelled outside of Canada? *

Yes
No

Please acknowledge the Stabback Music Studio's COVID-19 Policies by reading and checking each statement: *

I understand that if the answer is "yes" to any of the COVID-19 screening questions listed above then the student is unable to attend an in-person lesson at this time. Instead the lesson will be offered in an online format.
I understand that parents and students will be required to wear a mask while in the building. This includes the time before, after, and during the lesson.
I understand that the temperature of students and parents will be taken before they can enter the building.

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