Hull City Ladies > COVID Screening Form

SELF-SCREENING CHECK LIST PRIOR TO EACH TRAINING SESSION/MATCH DAYS

Each participant including staff and players should self-screen prior to arrival at training to ensure they do not have any of the following symptoms as these are potential indicators of COVID– 19.

Parents must submit this for players under the age of 18.

    A high temperature above 37.8 degrees?
    PositiveNegative

    A new continuous cough?
    PositiveNegative

    Shortness of breath?
    PositiveNegative

    A sore throat?
    PositiveNegative

    Loss of or change in normal sense of taste or smell?
    PositiveNegative

    Feeling generally unwell?
    PositiveNegative

    Persistent tiredness?
    PositiveNegative

    Been in close contact with/living with a suspected or confirmed case of COVID-19 in the previous two weeks?
    PositiveNegative

    Player/Staff Name:

    Date:

    Parent name if player is under 18.