Aurora Master Ducks

Covid-19 Self Assessment

    If you answer YES to ANY of the questions below, STAY HOME and

    1. Call your COVID-19 Coordinator (Kelly Hughes 416-418-3960)
    2. Monitor your symptoms
    3. Get tested if you have had known exposure to COVID-19 and/or you are experiencing any of the symptoms above, even if mild.
    4. If you test positive for COVID-19, contact your healthcare provider for advice.
    5. If at any time a doctor confirms, through a negative COVID-19 test, that the cause of fever or other symptoms are NOT COVID-19 related you may return to practice once the symptoms have subsided and you are feeling well again.

    If you start feeling sick during your practice, let your coach(es) know and follow the protocol above.

    Full Name:

    Date:

    • Have you been diagnosed with COVID-19, or are you waiting to hear the results of a lab test for COVID-19?
      yesno
    • Have you been in contact with a suspected, probable, or confirmed case of COVID-19 in the past 14 days?
      yesno
    • Have you been told by public health that you may have been exposed to COVID-19?
      yesno
    • Have you returned from a trip outside of the country in the last 14 days?
      If exempt from federal quarantine requirements (for example, you are fully vaccinated and have met the specific conditions, or an essential worker who crosses the Canada-US border regularly for work), select “No.”
      yesno
    • Have you experienced any of the following symptoms of COVID-19, even if mild:

      • cough
      • shortness of breath
      • chest pain
      • difficulty breathing
      • fever
      • chills
      • abnormal muscle pain
      • headache, sore throat
      • painful swallowing
      • runny nose
      • new loss of taste or smell
      • gastrointestinal illness

      yesno