Scecina Track Symptom Tracking

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This form is required to be filled out before each sports practice/event by every athlete in order for the athlete to participate. Mask are REQUIRED by all athletes until they clear the screening process.

Athlete Name *

Symptoms

Mark yes or no to each of the below symptoms.

Temp above 100.3 *

Yes

Shortness of breath *

Yes

Loss of taste or smell *

Yes

Cough *

Yes

Sore Throat *

Yes

Chest pain *

Yes

Nausea/vomitting *

Yes

Diarrhea *

Yes

Chills *

Yes

Headache *

Yes

Conclusion

SEND HOME and DO NOT PRACTICE: if athlete has temperature above 100.3 or any YES in the first 3 symptoms OR more symptoms in the other columns they CANNOT PRACTICE.

If athlete is sent home, they MUST have WRITTEN clearance from a physician before they can participate in the next practice. If there needs to be further evaluation please send athlete to your athletic Trainer before participating.

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