COVID-19 Self-Assessment Form

In compliance with the City of Ottawa Regulations, each and every individual who wishes to access NSC property is required to complete the following form within 24 hours of visiting NSC.

The personal information collected in the following form is for the sole purpose of meeting the Provincial and Municipal requirement for contact tracing, should there be a known exposure to COVID-19. The information will not be used for any other purpose, nor will it be shared, or sold to any third party. Information more than 30 days old will be deleted on a periodic basis.

In the form, please enter your Membership/Member number as written on your access card, including the “hyphen”, as this is the primary contact tracing identifier.

The Form

Note: After submission, scroll up to the top of form to see the confirmation.

Last Updated: 2021-06-08.

******** This page must be edited by “the boss” as it contains HTML special tags. ********

2021-04-19, DS: added “Additional Instructions”.
2021-04-08, DS: changed words to “Stay at Home”.
2021-04-03, DS: added details about data retention.
2021-04-02, DS: new page. HM: added “Page updated”, minor grammar correction.
2021-06-07, HM:
Changed title from “Spring 2021 Yard Signup and COVID-19 Self-Assessment Form” to simply “COVID-19 Self-Assessment Form”.
Removed reference to “NSC Yard” and “Stay at Home order (April 8 to May 6)”.
Removed all Special Instructions (wear a mask while on NSC premises, and not use their vessel for recreational boating).
2021-06-08, HM: Replaced “The information will be deleted 30 days after the end of the lockdown” with “Information more than 30 days old will be deleted on a periodic basis.”

NOTE: Update the publish date and time when updating page.

Page maintained by Webmaster.