Return to Skating

This questionnaire must be completed daily by each individual prior to participation in any sessions.

If an individual answers YES to any of the questions, they are not allowed to attend or participate in the sport or activity. Children and youth will need a parent to assist them to complete this screening tool.

*Individuals with fever, cough, shortness of breath, runny nose, or sore throat, are required to isolate for 10 days per CMOH Order 05-2020 unless they receive a negative COVID-19 test and are feeling better. Use the AHS Online Assessment Tool to determine if testing is recommended and follow information on isolation requirement.

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* 1. Does the attendee have any new onset (or worsening) of any of the following symptoms: fever*, cough*, shortness of breath/difficulty breathing*, sore throat*, runny nose/nasal congestion*, chills, painful swallowing, feeling unwell/fatigued, nausea/vomiting/diarrhea, unexplained loss of appetite, loss of sense of taste or smell, muscle/joint aches (unrelated to training), headache, conjunctivitis (i.e., pink eye)?

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* 2. Has the attendee travelled outside of Canada in the last 14 days? Note: Individuals legally required to quarantine for 14 days when entering or returning to Alberta from outside Canada.

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* 3. Has the attendee had close contact with a confirmed case of COVID-19 in the last 14 days? Note: Face-to-face contact within 2 metres. A health care worker in an occupational setting wearing recommended personal protective equipment is not considered to be a close contact.

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* 4. Has the attendee had close contact with an individual who has any one of the first 5 symptoms on this list (fever*, cough*, shortness of breath/difficulty breathing*, sore throat*, runny nose/nasal congestion*) AND who is a close contact of a confirmed cased of COVID-19 in the last 14 days?

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* 5. If you have answered YES to any of the above questions, do not participate. Stay/proceed home and use the AHS Online Health Assessment Tool to determine if testing is recommended.

If you have answered NO to all of the above questions, please enter the following information in the box below:

Name(s) of All Attendees:
Address:
Email:
Emergency Contact Name and Cell Number:

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* 6. Please enter today's date

Date
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