Daily Screening Checklist (adult)

DISCLAIMER: By entering your name below you acknowledge that the information provided in this checklist is true and accurate.

Will be updated to reflect any Government of Alberta and Alberta Health Services changes to questions and requirements.
Alberta Gymnastics Federation | Last Updated: June 10, 2020

1. Do you have any of the below symptoms: 

• Fever (greater than 38.0C)
   YES  NO
   
• Cough
   YES  NO
   
• Shortness of Breath / Difficulty Breathing
   YES  NO
   
• Sore throat
   YES  NO
   
• Chills
   YES  NO
   
• Painful swallowing
   YES  NO
   
• Runny Nose/Nasal Congestion
   YES  NO
   
• Feeling unwell/Fatigued
   YES  NO
   
• Nausea/ Vomiting/ Diarrhea
   YES  NO
   
• Unexplained loss of appetite
   YES  NO
   
• Loss of sense of taste or smell
   YES  NO
   
• Muscle / Joint aches
   YES  NO
   
• Headache
   YES  NO
   
• Conjunctivitis
   YES  NO

2. Have you, or anyone in your household travelled outside of Canada in the last 14 days?
  YES  NO

3. Have you or your children attending the program had close unprotected contact (face-to-face contact within two-meters) with someone who is ill with cough and/or fever?
  YES  NO

4. Have you or anyone in household been in close unprotected contact in the last 14 days with someone who is being investigated or confirmed to be a case of COVID-19?
  YES  NO

If an individual answers YES to any of the questions, they must not be allowed to participate in the sport or activity. Proceed home and use the AHS Online Assessment Tool to determine if testing is recommended.