BUCS Covid-19 Health Questionnaire
Self - Assessment Questionnaire to be completed by all competitors, staff, officials and volunteers before arriving at the event. If your situation/symptoms change after you have submitted the form please resubmit this questionnaire. If this means you are no longer able to participate in the event please notify the event manager as well as your institution.
Sign in to Google to save your progress. Learn more
BUCS Covid Measures
For more information around BUCS Covid-19 measures please visit our website. https://www.bucs.org.uk/return-to-play/covid-19-measures.html
Name: *
Please provide first and last name
E-mail address *
What event are you participating in? *
Do you have any of the following symptoms:
A high temperature, fever or chills (shivering) – this means you feel hot to touch on your chest or back (you do not need to measure your temperature) *
A new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual) *
A loss or change to your sense of smell or taste – this means you've noticed you cannot smell or taste anything, or things smell or taste different to normal *
Have you been ill with any of the above symptoms in the last 7 days? *
Has anyone in your current household been ill with any of the above symptoms in the last 14 days, or have you been in close contact with a definite confirmed case of coronavirus in the last 14 days, or have you been contacted by NHS track & trace? *
Have you travelled internationally and returned to the UK in the past 14 days from a country outside of the government’s current common travel area? *
Have you knowingly been in contact with any person who has returned from a country outside of the government’s current common travel area in the last 14 days? *
I declare that all the information given on this form is true and accurate
If you have answered "YES" to any of the above questions - access to the event will be denied.
What university do you attend? *
Date *
MM
/
DD
/
YYYY
What is your role at the event? *
Next
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy