Dear Staff Member,
In line with our Covid-19 procedures, all Club staff are required to self-screen and complete this self-screening form on a daily basis before attending the Club. This form will be emailed to the Covid Club Lead when you press :: SEND ::
Have you been in contact with a case of COVID-19?
Have you been contacted by a member of public health about a recent case of COVID-19?
Do you have now, or have you had in the last 24 hours, any of the following symptoms? :
Shortness of breath
Excessive fatigue/tiredness (out of proportion to normal)
Loss or change to your sense of smell or taste?
(This means you've noticed you cannot smell or taste anything, or things smell or taste different to normal)
Please take your temperature and write it down here:
(Please alert Covid Club Lead if this is more than 38 degrees celcius)
[radio* signed id:signed class:signed label_first default:1 "No" "Yes"]