Harris Institute Student Screening

After submission, you will receive a copy of your completed form to the email address provided below. 

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Are you experiencing any of the following symptoms:

In the last 14 days have you:

Commitment to this plan

By signing this form, I certify that I understand the importance of the quarantine procedure upon arrival in Canada, and will follow all criteria provided in this document, as well as all requirements provided by the Government of Canada, for a full 14 days.
(type your name)
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