Questionnaire Covid
Sign in to Google to save your progress. Learn more
Nom complet *
Full name
Avez-vous des symptômes tels que essoufflement, fièvre, perte de goût ou d’odorat, fatigue, toux ? *
Do you have symptoms such as difficulty to breathe, fever, loss of taste or smell, fatigue, or cough?
Avez-vous été en contact étroit avec une personne ayant reçu un test positif à la Covid ou présentant des symptômes de Covid au cours des 14 derniers jours ? *
Were you in close contact with a person who has received a positive test to Covid-19 or presenting Covid-19 related symptomes in the last 14 days?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Club de Volleyball Everton. Report Abuse
Google Forms