Covid-19 Health Screening
As we stay apprised of the current Covid environment, the A-GAME Leadership remains committed to maintaining a safe working environment. At this convening in Denver, Colorado, we are following CDC guidelines, which includes completing a Covid-19 screening each morning of the event, wearing a mask, and keeping in small groups, and social-distancing.

Please complete the following Covid-19 health screening form each morning of the event by 9:00 AM EST.
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Have you been exposed to anyone who tested positive for Covid-19 in the past 14 days? *
Required
Have you had any of the following symptoms in the last 48 hours? (Fever or Chills, Cough, Shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea). *
Required
I verify that the information I provided is true.
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of National Charter Schools Institute. Report Abuse
Google Forms