2021 Ultimate Frisbee Covid screening Tool

Please fill out the form below.

Everyone is required to fill out and submit the covid screening tool before each game each week.

If you answer NO to ALL of the questions below hit submit and you are eligible to play this evening.

If you answered YES to any of the these questions, notify your workplace, go home and self-isolate right away.

Call your health care provider or the COVID-19 Info-Line at 905-688-8248 and a public health professional
will give you detailed instructions to follow to protect you, your family and members of the public.

Novel Coronavirus (COVID-19) Info-Line
Talk to a public health professional Monday to Friday from 9:15 a.m. to 8:30 p.m.,
and Saturday and Sunday from 9:15 a.m. to 4:15 p.m.
905-688-8248 press 7, then press 2 Toll-free: 1-888-505-6074

Covid screening tool

Name*
First Last
Phone*
Team*
Do you have any of the following?
- Fever Chills
- New cough or a cough that is getting worse
- Difficulty breathing
- Shortness of breath (even when sitting or walking regularly)
- Sore throat (not due to allergies)
- A runny or congested nose (not due to allergies)
- Unusual level of fatigue
- Unusual headache
- Nausea / vomiting, diarrhea, or loss of appetite
- Feeling unwell for an unknown reason
- Have you been in close contact with someone who is either sick, sent for testing, or has confirmed COVID-19 in the past 14 days?
- Have you returned from travel outside Canada in the past 14 days?
Check only boxes you are answering "Yes" to
Do you have any of the above symptoms?*
- No - I have read the screening tool and have none of the above symptoms today.
- Yes - I have one or more of the symptoms above
Unfortunately you are not eligible to play today. If you answered YES to any of the these questions, notify your workplace, go home and self-isolate right away. Call your health care provider or the COVID-19 Info-Line at 905-688-8248 and a public health professional will give you detailed instructions to follow to protect you, your family and members of the public. Novel Coronavirus (COVID-19) Info-Line Talk to a public health professional Monday to Friday from 9:15 a.m. to 8:30 p.m., and Saturday and Sunday from 9:15 a.m. to 4:15 p.m. 905-688-8248 press 7, then press 2 Toll-free: 1-888-505-6074
Congratulations you are eligible to play. Have fun at the game and if you experience any of the above symptoms please leave the game/ park and contact public health.