Health Screen Survey for Returning to Training
You will be aware of the ongoing outbreak of COVID-19. Garioch Amateur Swimming Club are adhering to guidance from Scottish Government and Public Health Scotland in containing the virus and ensuring a safe environment for athletes and staff.

As one of our measures, we are seeking to identify any potential cases at the earliest opportunity to avoid any contact/spread. The research to date for this novel virus suggests that transmission appears to be during symptomatic phase, and as such, identifying those with symptoms and isolating them should reduce risk significantly.

*** PLEASE COMPLETE THIS FORM ONCE BEFORE RETURNING TO TRAINING OR AGAIN IF RETURNING TO TRAINING AFTER A PERIOD OF ILLNESS OR CIRCUMSTANCE CHANGE ***

If you are answering on behalf of a child, by checking the boxes below you agree that you have clearly advised your child of the statements and that your child agrees to them.

If you have any questions, please speak to our club's Lead COVID-19 Officer Matt Cowan as soon as possible on 07706 058179 or email him on officials@gasc.co.uk
Please enter your own or your child's full name. *
*** PLEASE NOTE, WE REQUIRE EACH CHILD, VOLUNTEER AND COACH TO COMPLETE A SEPARATE HEALTH SCREEN SURVEY BEFORE THEY RETURN TO TRAINING ***
Are you a: *
If you are a child, which Squad or Session are you in? *
Required
1. Do you have or have you had any of the following symptoms in the last 48 hours? For a full list of symptoms and for more information please go to: https://www.nhsinform.scot/illness-and-conditions/infections-and-poisoning/coronavirus-covid-19 *
Yes
No
A new continuous cough
A high temperature of fever
Loss of taste or smell
2. Have you had a known exposure to anyone with confirmed or suspected COVID-19 in the last two weeks? (e.g. close contact, household member) *
3a. Have you been asked to self-isolate within the last 14 days? *
3b. If Yes, what date did your self-isolation period begin?
MM
/
DD
/
YYYY
4. Do you agree to inform the club if you have any physical or mental health conditions that the club are not aware of that would affect your ability to train / return to training? *
5. Have you travelled to any country (outside of the UK) in the last 14 days? *
6. Any additional comments?
If you have answered Yes to questions 1, 2, 3 or 5 above, please notify the Lead COVID-19 Officer Matt Cowan immediately on 07706 058179.

You may need to seek the appropriate medical or further advice before restarting training. You should not travel to the pool or any land-based training until this has been done.
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