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Holy Blossom Temple: Self-Assessment - One per Household  

To prevent the spread of COVID-19, to reduce the potential risk of exposure to our workforce and visitors, and to assist in any future contact-tracing, we thank you in advance for taking the time to fill out this brief self-assessment each day you visit HBT.

For details on COVID protocols in place at Holy Blossom Temple at this time, please visit:

1. Today, or in the last 5* days,
have you experienced any of these symptoms? Fever or chills, new or worsening cough, new or worsening shortness of breath, runny nose or nasal congestion, sore throat, decrease or loss of sense of taste or smell, new or unexplained nausea, vomiting, diarrhea. abdominal pain, known or diagnosed pneumonia??

2. In the last 5* days, has any member of your household tested positive for COVID-19 or been told to stay home and self-isolate?

In the last 5* days, has any member of your household developed or experienced 1 or more new or worsening symptoms as outlined in #1 above?

In the last 14 days, have you or anyone in your household traveled outside of Canada in the last 14 days AND been advised to quarantine per the federal quarantine requirements?

*10 days for any household member who is immunocompromised or unvaccinated