Covid-19 Self Check

Generated with MOOJ Proforms Version 1.5

Everyone who will be either playing or on the field for the 2020/21 season MUST fill up this form.

This form must be filled up no earlier than 9am the day of your match EVERY WEEK. 

Team Officials are no longer required to monitor the Health Check portion for practices and games. Participants and team officials are now responsible for completing their own health check using the BC COVID-19 Self-Check and follow the recommendations outlined by the Ministry of Health and the BCCDC. Although we don't have the tracking option that we did with TeamSnap, this tool is based on the most up to date COVID-19 information in BC and provides instruction to individuals on the next steps if they fail portions of questions. 

Team Officials should send out the following weekly reminder email to teams:

Dear CMF Member,

This is your reminder to not attend the session if:

  1. you don’t feel well or are displaying symptoms of COVID-19
  2. someone in your household has COVID-19 or is showing symptoms of COVID-19
  3. you have traveled outside of Canada within the last 14 days

Please ensure you utilize the BC COVID-19 Self-Assessment Tool in ANY LANGUAGE and complete prior to attending training/game. The language for the tool may be adjusted at the top right corner of the screen.


 

 

*Required information.

**This form must be filled up no earlier than 9am the day of your match EVERY WEEK. 
Any submisions not on the day of thr match will be discarded and not alegible to play


Are you experiencing any of the following:

 

  • Severe difficulty breathing (e.g. struggling to breathe or speaking in single words)
  • Severe chest pain
  • Having a very hard time waking up
  • Feeling confused
  • Losing consciousness
*

 


Are you experiencing any of the following:

  • Mild to moderate shortness of breath
  • Inability to lie down because of difficulty breathing
  • Chronic health conditions that you are having difficulty managing because of difficulty breathing

*

 


Are you experiencing cold, flu or COVID-19-like symptoms, even mild ones?

Symptoms include: Fever*, chills, cough or worsening of chronic cough, shortness of breath, sore throat, runny nose, loss of sense of smell or taste, headache, fatigue, diarrhea, loss of appetite, nausea and vomiting, muscle aches.

While less common, symptoms can also include: stuffy nose, conjunctivitis (pink eye), dizziness, confusion, abdominal pain, skin rashes or discoloration of fingers or toes.

Fever: Average normal body temperature taken orally is about 37°C. For more on normal body temperature and fevers, see HealthLinkBC's information for children age 11 and younger

and for people age 12 and older .

 

*

 


Have you travelled to any countries outside Canada (including the United States) within the last 14 days?

 

*

 


Did you provide care or have close contact with a person with confirmed COVID-19?

Note: This means you would have been contacted by your health authority’s public health team.

 

*

 


Do you believe you have been in recent contact with someone who tested possitive for Covid-19?

 

*

 


Did you answer any of these questions "Yes"

 

*

 


If you ahev answered ANY of these questions "Yes", please DO NOT come to the soccer field and notify your team manager immediately as well as take the necessary precautions of self-isolation and contact your doctor.

 

About BMSL

The BMSL is a men's soccer league, with all games played within Burnaby BC, mainly at Burnaby Lake Sports Complex West (near Kensington and Sprott)

© 2018 Burnaby Men's Soccer League. All Rights Reserved. Developed by Bravo Media Design

Search