OHF Health Screening Questionnaire
This questionnaire must be completed by each individual prior to participation in each on-ice or off-ice
activity
Email address *
Are you currently experiencing any of these issues? Call 911 if you are. 1. Severe difficulty breathing (struggling for each breath, can only speak in single words)? 2. Severe chest pain (constant tightness or crushing sensation)? 3. Feeling confused or unsure of where you are? 4. Losing consciousness? *
Required
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