TBVC Daily Health Screening Questionnaire
This questionnaire must be completed by each individual prior to participation in today's volleyball session. In order to participate in today's session the answer to all the questions must be "No".
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Your Name *
League/Team *
Required
1. Do any of the following international travel scenarios apply to you? *
Required
2. In the last 5 days, have you experienced any of these symptoms? *
Required
3. In the last 5 days, have you tested positive for COVID-19? *
4. Do any of the following apply? *
Required
5. Has a doctor, health care provider, or public health unit told you that you should currently be isolating (staying at home)? *
Required
6. Have you been identified as a “close contact” of someone who currently has COVID-19 and been advised to self-isolate? *
Required
SUMMARY
If an individual answers "yes" to any of these questions, except question 1, they are not permitted to participate in today's session.

Please note: This Health Screening questionnaire has been developed based on the current Ontario Ministry of Health Self-Assessment Tool.
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