Jr. Provincial Daily Health Screening
This tool is meant to be used to assist with assessing attendees who may be symptomatic, or who may have been exposed to someone who is ill or has confirmed COVID-19.

Please complete this checklist prior to EVERY practice. If an individual answers yes to any of the questions, they CANNOT participate in the sport for everyone's safety. Children and youth will need a parent to assist them to complete this screening tool.

* Face-to-face contact within 2 metres. A health care worker in an occupational setting wearing the recommended personal protective equipment is not considered to be a close contact.

** ‘Ill/symptomatic’ means someone with COVID-19 symptoms on the list above.

If you have answered “yes” to any of the above questions do not participate. Go home and use the AHS
Online Assessment Tool to determine if testing is recommended.
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Email Address *
Name of Athlete, Coach or Volunteer *
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