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SHARKS IMX Meet #1 Health Questionnaire
All participants, coaches & volunteers at the meet will need to complete this form prior to coming into the building for the meet - THIS FORM SHOULD BE COMPLETED ON THE DAY YOU ARE ATTENDING - NOT BEFORE
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* Indicates required question
Email
*
Your email
Your name
*
Your answer
Participants role in the meet
*
Swimmer- SHRK
Swimmer- FCST
Swimmer - PEAK
Coach
Official
Timer
Safety Marshall
Additional Team Volunteer
Do you have any of the following symptoms that are not caused by another condition?
*
Fever or chills
cough
shortness of breath or difficulty breathing
fatigue
muscle or body aches
headache
recent loss of taste or smell
sore throat
congestion
nausea or vomiting
none of the above
Required
Within the past 14 days, have you had contact with anyone that you know had COVID or COVID-like symptoms? Contact is being 6 feet or closer for more than 15 minutes with a person, or having direct contact with fluids from a person with COVID.
*
Yes
No
Have you had a positive COVID test for active virus in the past 10 days?
*
Yes
No
Within the past 14 days, has a public health or medical professional told you to self-isolate or self-quarantine because of concerns about COVID infection?
*
Yes
No
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