U9 #1 / OMHA Health Screening Questionnaire (Midland Minor Hockey Association)

U9 #1 / OMHA Health Screening Questionnaire

Session Participation Tracking

The expectation is that a tracking sheet must exist for each on-ice session to facilitate contact tracing in the event of a COVID-19 exposure.

Are you currently experiencing any of these symptoms?

The answer to all questions must be “No” in order to participate in any and all activity.

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.

If an individual has answered “Yes” to any of these questions, they are not permitted to participate in any on-ice or off-ice activities.

Please note: This Health Screening questionnaire has been developed based on the Ontario Ministry of Health Self-Assessment Tool (September 14, 2020).