Swimmer COVID Screening - Intrasquad (Jan 24)
Swimmers must complete this screening the day of the meet, but at least 30 minutes prior to the start of the first event in their session.  Your responses are timestamped.  Anyone who submits their responses after the deadline will not be allowed to participate in the swim meet.
登入 Google 即可儲存進度。瞭解詳情
電子郵件 *
Swimmers First Name *
Swimmers Last Name *
Session / Events *
Screening Questions *
Y
N
Is your temperature above 100.0°F?
Have you been exposed to anyone known to have COVID 19?
Are you currently being required to quarantine due to an exposure to COVID19?
Is someone in your household on quarantine due to COVID19?
Are you waiting for COVID19 test results?
Are you experiencing any of the following symptoms? Fever, Chills, Cough, Shortness of Breath, Difficulty Breathing, Fatigue, Muscle Aches, Headache, New Loss of Taste or Smell, Sore Throat, Congestion, Runny Nose, Nausea, Vomiting or Diarrhea.
If you answered yes to any of the above screening questions please explain.
Notes / Comments
系統會透過電子郵件將你的作答內容複本傳送到你所提供的地址。
提交
清除表單
請勿利用 Google 表單送出密碼。
Google 並未認可或建立這項內容。 檢舉濫用情形 - 服務條款 - 隱私權政策