EFAC U18 AA Alberta Health Daily Checklist - PLAYER (UNDER 18 YEARS)
Pursuant to the AHS and Hockey Edmonton requirements, this form must be submitted ON THE SAME DATE AS THE ICE TIME/ACTIVITY, and no later than 2 hours prior to that scheduled ice time/activity. Please DO NOT complete the night before as the date will be incorrect and the player will not be allowed to participate.

Overview:
This checklist applies for all children, as well as all students who attend kindergarten to Grade 12, including high school students over 18. Children should be screened every day by completing this checklist before going to school, child care or other activities. Children may need a parent or guardian to assist them to complete this screening tool.

If you have traveled outside Canada in the last 14 days, follow the Government of Canada Travel, Testing, Quarantine and Borders instructions, including any requirements for exempt travelers related to attending high-risk environments.

As the COVID-19 pandemic continues to evolve, this screening tool will be updated as required.
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Name *
Email address *
Date of activity *
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Question 1:
Do you have any new onset (or worsening) of the following core symptoms:
Fever: Temperature of 38 degrees Celsius or higher *
Cough: Continuous, more than usual, not related to other known causes or conditions such as asthma *
Shortness of breath: Continuous, out of breath, unable to breathe deeply, not related to other known causes or conditions such as asthma *
Loss of sense of smell or taste: Not related to other known causes or conditions like allergies or neurological disorders *
If you answered “YES” to any symptom in question 1:
- You are required to isolate for 10 days as per CMOH Order 39-2021 and testing is recommended
OR
- receive a negative COVID-19 test and feel better 9even if the 10 days is not completed) before returning to activities.
- Use the AHS Online Assessment Tool or call Health Link 811 to arrange for testing and to receive additional information on isolation.

If you  answered “NO” to all of the symptoms in question 1:
- Proceed to Question 2
Question 2:
Do you have any new onset (or worsening) of the following other symptoms:
Chills: Without fever, not related to being outside in cold weather *
Sore throat/painful swallowing: Not related to other known causes/conditions, such as seasonal allergies or reflux *
Runny nose/congestion: Not related to other known causes/conditions, such as seasonal allergies or being outside in cold weather *
Feeling unwell/fatigued: Lack of energy, poor feeding in infants, not related to other known causes or conditions, such as depression, insomnia, thyroid dysfunction or sudden injury *
Nausea, vomiting and/or diarrhea: Not related to other known causes or conditions, such as anxiety, medication or irritable bowel syndrome *
Unexplained loss of appetite: Not related to other known causes or conditions, such as anxiety or medication *
Muscle/joint aches: Not related to other known causes or conditions, such as arthritis or injury *
Headache: Not related to other known causes or conditions, such as tension-type headaches or chronic migraines *
Conjunctivitis: Commonly known as pink eye *
If you answered “YES” to ONE symptom in question 2:
- Stay home and monitor for 24 hours.
- If your symptom is improving after 24 hours, you can return to ice/activity when you feel well enough to go. Testing is not necessary.
- If the symptom does not improve or worsens after 24 hours (or if additional symptoms emerge), testing is recommended.  You can return to ice/activities when your symptoms have resolved AND it’s been at least 24 hours since your symptoms started.

If you answered answered “YES” to TWO OR MORE symptoms in question 2:
- Stay home. Testing is recommended
- You can return to ice/activities when your symptoms have resolved AND it’s been at least 24 hours since your symptoms started.

If you answered “NO” to all questions:
- You may attend ice/activities.
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