COVID-19 HEALTH SCREEN

Required before entering the dojo + temperature check.

1. In the past 24 hours, have you experienced one of the following:

 

a.   New onset cough

b.   Shortness of breath or difficulty breathing

c.   New loss of smell or taste

d.   Temperature of 100.4 degrees Fahrenheit or greater

Temperature of 99.2 or higher but less than 100: You must begin monitoring your temperature twice a day for 7 days to determine if the temperature is going up or down. After 7 days, you may return. A health screen must be completed within 1 hour of entering the dojo/attending class.

 

If YES to any of these questions, no further screening is necessary.

The person may not enter the dojo.

 

If NO, go to the next question, No. 2.

 

 

2. In the past 24 hours, have you experienced any of the following:

 

a.   Headache

b.   Fatigue

c.   Muscle or body aches

d.   Runny nose, sniffles

e.   Sore throat

f.    Congestion

g.   Nausea, vomiting, diarrhea

h.   And other new symptoms unrelated to allergies or previous conditions

 

If YES to any of these questions, no further screening is necessary.

The person may not enter the dojo.

 

If NO, go to the next question, No. 3.

 

 

If any of the symptoms in No. 1 and No. 2 develop within 3 days after practice, you must notify Ikeda sensei as soon as possible.

 

People with any of the symptoms in Questions No. 1 and No. 2. should isolate at home for at least 24–72 hours since the last sign of fever, when symptoms have improved, and at least 10 days from the start of symptoms whichever is longer.

 

 

3. To the best of your knowledge, in the past 14 days, have you had close contact with someone with a confirmed diagnosis of COVID-19?

 

Contact is being 6 feet or closer for at least 10 minutes with a person, or having direct contact with fluids from a person with COVID-19 (i.e., being sneezed or coughed on).

 

If YES to any of these questions, no further screening is necessary.

The person may not enter the dojo.

 

If NO, go to the next question, No. 4.

 

 

4. In the past 10 days, have you had a positive COVID-19 test for active virus using a test that tested saliva or used a nose or throat swab (not a blood test)?

 

If YES to any of these questions, no further screening is necessary.
The person may not enter the dojo.

 

If NO, go to the next question, No. 5.

 

 

5. Within the past 14 days, has a public health or medical professional told you to self-monitor, self-isolate, or self-quarantine because of concerns about COVID-19 infection?

 

If YES to any of these questions, no further screening is necessary.

The person may not enter the dojo.

 

If NO, go to the next question, No. 6.

 

 

6. Within the past 14 days, have you dined indoors at a restaurant? Have you traveled out of state or internationally?

 

 If YES was the answer to any of the above questions, the individual is

NOT permitted to enter the premises of Boulder Aikikai.

2424 30th Street Boulder, CO 80301 | (303) 444-7721

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