Self-Screening Assessment for COVID-19

This self-assessment was adapted from Football Ontario's Return to Football Guidelines found here:

This is to be completed every day before going to the field.

  1. Have you travelled outside of Canada in the last 14 days? (does not apply to fully vaccinated individuals) YES or NO

  2. Has someone you are in close contact with tested positive for COVID-19 in the last 14 days? YES or NO

  3. Are you in close contact with a person:

    1. who recently travelled outside of Canada AND is sick with COVID-19 symptoms? YES or NO

    2. who is sick with new respiratory symptoms OR YES or NO

    3. who has symptoms and who is awaiting COVID-19 test results? YES or NO

  4. Do you have a fever? (temperature ≥ 37.8 °C) YES or NO

  5. Do you have any of these symptoms? YES or NO

    1. Chills

    2. New or worsening cough (dry or productive)

    3. Barking cough (croup)

    4. Shortness of breath/difficulty breathing

    5. Sore throat

    6. Difficulty swallowing

    7. Loss of taste or smell

    8. Pink eye (conjunctivitis)

    9. Headache that is unusual or long-lasting

    10. Runny or stuffy nose (not related to seasonal allergies or other known causes)

    11. Nausea/vomiting/diarrhea/abdominal pain

    12. Muscle aches

    13. Unexplained fatigue/malaise

    14. Falling more than usual

If you have answered:

  • NO to all questions

    • You may officiate the game(s) for today.

  • YES to any questions from #1 to #4

    • Notify the Assignor and President immediately to be removed from the game(s).

    • Take the self-assessment here and follow any recommendations given.

  • YES to #5 only – Go to question #6.

  1. Are these symptoms typical for you (i.e. history of allergies, migraines, other known medical conditions that usually cause these symptoms)?

    1. YES

      1. Contact your doctor for a note confirming that symptoms are typical.

    2. NO

      1. Notify the Assignor and President immediately.

      2. Take the self-assessment here, and follow any recommendations.

For details on self-isolation and what to do if you have symptoms, visit OPH COVID website.