Daily Practice COVID-19 Screening Checklist
The following checklist is to be completed for every Penguin Swimming and Penguin Masters Swimming swimmer PRIOR to EVERY practice. Swimmers will not be able to participate if the checklist has not been completed.

If a swimmer has traveled outside Canada in the last 14 days, follow the Government of Canada Travel, Testing, Quarantine and Borders instructions, including any requirements for exempt travelers related to attending high-risk environments.

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Email *
Swimmer's LAST Name *
Swimmer's FIRST Name(s) *
Todays' Date (practice date) *
MM
/
DD
/
YYYY
Swim Program *
CORE SYMPTOMS - Does your swimmer (or you as a Masters swimmer) have any new onset (or worsening) of any of the following CORE symptoms: *
YES
NO
Feaver (38 C or higher)
Cough (continuous, more than usual, not related to other known causes)
Shortness of Breath (continuous, out of breath, unable to breathe easy)
Loss of Sense of Smell or Taste (not related to other known causes like allergies)
CORE SYMPTOMS
PENGUIN SWIMMERS - answered YES to ANY of the above Core symptoms:
1. Your swimmer is REQUIRED to ISOLATE for 10 days from the onset of symptoms as per CMOH Order 39-2021 OR receive a negative COVID-19 test and feel better before returning to activities (including swimming).
2. Use the AHS Online Assessment Tool or call Health Link 811 to arrange for testing and to receive additional information on isolation.

MASTERS SWIMMERS - answered YES to ANY of the above Core symptoms:
1. Stay home. Do NOT ATTEND practice.
2. Use the AHS Online Assessment Tool or call Health Link 811 to arrange for testing and receive additional information on isolation.
3. You are REQUIRED to ISOLATE for 10 days as per CMOH Order 39-2021 OR receive a negative COVID-19 test and feel better before returning to activities (including swimming).

2. OTHER SYMPTOMS - Does your swimmer (or you as a Masters swimmer) have any new onset (or worsening) of any of the following OTHER symptoms: *
YES
NO
Chills (without fever)
Sore Throat / Painful Swallowing (not allergies)
Runny Nose / Congestion (not allergies)
Feeling Unwell / Fatigued (lack of energy)
Nausea, Vomiting and/or Diarrhea
Unexplained Loss of Appetite
Muscle / Joint Aches (not arthritis or injury)
Headache (not tension or migraine)
Conjunctivitis (Pink Eye)
OTHER SYMPTOMS
PENGUIN SWIMMERS - answered YES to ONE (1) of the above Other symptoms:
1. Keep swimmer at home and monitor for 24 hours. Do NOT ATTEND practice.
2. If the symptom is improving after 24 hours, they can return to school (and swimming) when they feel well enough to go. Testing is not necessary.
3. If 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.

PENGUIN SWIMMERS - answered YES to TWO (2) OR MORE of the above Other symptoms:
1. Keep swimmer at home. Do NOT ATTEND practice.
2. Use the AHS Online Assessment Tool or call Health Link 811 to determine if testing is recommended.
3. Your swimmer can return to school (and swimming) once their symptoms go away as long as it has been at least 24 hours since their symptoms started.

MASTERS SWIMMERS - answered YES to ANY of the above Other symptoms:
1. Stay home. Do NOT ATTEND practice.
2. Use the AHS Online Assessment Tool or call Health Link 811 to arrange for testing and receive additional information on isolation.
3. You are REQUIRED to ISOLATE for 10 days as per CMOH Order 39-2021 OR receive a negative COVID-19 test and feel better before returning to activities (including swimming).

A copy of your responses will be emailed to the address you provided.
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