COVID-19 Screening (NDMS) (Norwood Minor Hockey)

Print COVID-19 Screening (NDMS)
TO BE FILLED OUT WITHIN 2-6 HOURS PRIOR TO ARRIVAL AT THE ARENA. MUST BE COMPLETED FOR EVERY ON ICE SESSION - Practice or Game. Please read through the questionnaire and answer all of the questions. Please answer all questions accurately. Players who arrive at activities and appear to be symptomatic will not be allowed to participate. If your player is not feeling well, or showing any signs of any illness please keep them home. If you have any symptoms or answer yes you must stay home for a minimum of 24 hours after the last symptom subsides. You are given 2 options on the form: *PASS - answered "NO" to all questions and players are permitted to participate *FAIL- answered "YES" to any of the questions and players are NOT permitted to participate. Please notify Coach if your child is not attending and the reasons for missing, this is for tracking purposes. You will automatically get an email and will show this to the person filling out the tracking sheet
PLAYER IDENTIFICATION
1 FORM PER FAMILY Parent/Guardian - PLEASE LIST the individual who will be entering the arena with player.
  1. Example: [email protected] Your submission will be sent to this address.
  2. RadDatePicker
    RadDatePicker
    Open the calendar popup.
HEALTH SCREENING Part 1
Do you have any ONE of the following symptoms?
HEALTH SCREENING Part 2
Do you have any 2 or MORE of the following symptoms that is new OR persistent or worsening?
CRITICAL ASSESSMENT
Answer ALL Questions For the remaining questions, close physical contact means: Being less than 2 metres away in the same room, workspace, or area for over 15 minutes Living in the same home
Human Validation
Printed from norwoodminorhockey.com on Monday, January 25, 2021 at 12:08 AM