COVID-19 Athlete Screening Questionnaire
Swim Alberta requires all member organizations to track the attendance of all participants in any programming. On the program day and before the start of the event, you MUST answer the questions below to be eligible to participate.

* IF A COVID TEST IS REQUIRED YOUR SWIMMER WILL BE UNABLE TO RETURN TO PRACTICE UNTIL IT IS ADVISED AS SAFE TO DO SO BY ALBERTA HEALTH SERVICES*

** IF YOUR SWIMMER HAS ANY SYMPTOMS OF ILLNESS NOT RELATED TO COVID PLEASE KEEP THEM HOME UNTIL THEY ARE SYMPTOM FREE**

*** Should there be any discrepancy between the SRAY screening tool and Alberta Health, the Alberta Health recommendations will supersede this form.***

Alberta Health Screening Form
https://open.alberta.ca/publications/covid-19-information-alberta-health-daily-checklist

AHS Online Assessment Tool
https://myhealth.alberta.ca/Journey/COVID-19/Pages/COVID-Self-Assessment.aspx
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Email *
Swimmer's Name *
Swimming Cohort *
Date of Practice / Event *
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/
DD
/
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1. Has the participant or anyone in their household traveled outside of Canada within the last 14 days or had a close contact with a confirmed case of COVID-19 in the last 14 days? *
Face-to-face contact within 2 meters for 15 minutes or longer, or direct physical contact such as hugging
Required
If you answered “YES”:
You are required to quarantine for 14 days from the last day of exposure, except:

Previously tested positive for COVID-19 in last 90 days before exposure:
- No quarantine required. Monitor for symptoms for 14 days.

Fully immunized against COVID-19:
- No quarantine required. Monitor for symptoms for 14 days.

Partially immunized against COVID-19:
o Quarantine for 10 days. If tested on day 7 or later after exposure, quarantine ends after receiving a
negative test result.


If the child develops any symptoms, use the AHS Online Assessment Tool or call Health Link 811 to determine if testing is recommended.

If the child answered “NO” to both of the above:
Proceed to question 2.
2. Does the child have any new onset (or worsening) of the following core symptoms: *
Yes
No
Fever
Cough
Shortness of breath
Loss of sense of smell or taste
If the child answered “YES” to any symptom in question 2:

The child is to isolate for 10 days from onset of symptoms OR receive a negative COVID-19 test and feel
better 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 the child answered “NO” to all of the symptoms in question 2, proceed to question 3.
3. Does the child have any new onset (or worsening) of the following other symptoms: *
Yes
No
Chills
Sore throat/painful swallowing
Runny nose/congestion
Feeling unwell/fatigued
Nausea, vomiting and/or diarrhea
Unexplained loss of appetite
Muscle/joint aches
Headache
Conjunctivitis
If the swimmer answered “YES” to ONE symptom in question 3:

Keep your swimmer home and monitor for 24 hours. If their symptom is improving after 24 hours, they can return to swimming when they 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), use the AHS Online Assessment Tool or call Health Link 811 to check if testing is recommended.

If the swimmer answered “YES” to TWO OR MORE symptoms in question 3:

Keep your swimmer home. Use the AHS Online Assessment Tool or call Health Link 811 to determine if testing is recommended. Your child can return to swimming once their symptoms go away as long as it has been at least 24 hours since their symptoms started.

If the swimmer answered “NO” to all questions:

Swimmer may attend swimming.
A copy of your responses will be emailed to the address you provided.
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