Forge COVID-19 Symptom Checker
This Symptom Checker has been developed based upon the World Rugby's COVID-19 Symptom Checker template, and must be completed by each Pittsburgh Forge member prior to participation in a Forge sponsored event.  Failure to complete prior to training/match (or answering "yes" to any of the following questions) will result in disqualification for that day's event.

This must be resubmitted each day prior to a Forge event, whereas the Forge's Participant Waiver of Liability must only be completed once during the Spring 2021 season.  
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Email *
Full Name *
Are you currently diagnosed with, or believe you may have, COVID-19?   *
In the past 14 days, have you experienced the following symptoms of COVID-19? *
Please provide an answer for each of the symptoms below.  (1) For those experiencing side effects from a vaccine dosage (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/expect/after.html), those are not considered to be COVID-19 symptoms for the purpose of this symptom checker. Individuals should still remain away from Forge events while these side effects persist.   (2) For fully vaccinated individuals (i.e 2 weeks passed since final dose), experiencing the below symptoms following a known COVID exposure may be indications of COVID-19 infection (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html).
Yes
No
High Temperature/Fever
New/Continuous Cough or Sore Throat
Unexplained Shortness of Breath
New Loss of Taste/Smell
Cold/Flu Symptoms
Have you  been in contact with an individual confirmed or suspected to have COVID-19 in the past 14 days? *
Per CDC Guidelines (https://www.cdc.gov/coronavirus/2019-ncov/vaccines/fully-vaccinated.html), if you are considered to be fully vaccinated (i.e. 2 weeks have passed since your final vaccine dose), you may answer "No" to this question unless you have experienced symptoms listed above following a known exposure.
Symptom Checker Summary *
A copy of your responses will be emailed to the address you provided.
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