PVS 2021 SC Champs - Wave II Health Check (Coaches, Officials, Timers, Volunteers)
Please complete this form within 4 hours of arriving at the pool. If you answer yes to any of the following questions, do not come to the pool.
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Email *
Last Name *
First Name *
In the past 24 hours, have you had any of the following: *
Yes
No
A new fever (100.4 or higher) or a sense of having a fever?
Taken medication to reduce a fever?
A new cough that you cannot attribute to another heath condition?
New shortness of breath that you cannot attribute to another health condition?
A new sore throat that you cannot attribute to another health condition?
New muscle aches (myalgia) that you cannot attribute to another health condition or that may have been caused by a specific activity (such as physical exercise)?
A new onset of loss of sense of taste or smell?
Nausea or vomiting?
Diarrhea?
Congestion or runny nose?
Have you been around someone who is sick?
Have you been around someone who has tested positive for COVID-19?
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