Huron Valley Schools Athlete Health Screening
In accordance with Executive Orders, you are required to participate in the following daily health screening to prevent the spread of COVID-19.

Please answer the questions honestly and to the best of your knowledge.

Sign in to Google to save your progress. Learn more
Email *
I, the undersigned, will answer the following questions from all sections truthfully and to the best of my knowledge. By signing, I also recognize the expectation of maintaining social distancing by keeping a six-foot radius between myself and others. (Please enter your first and last name in the text field below) *
Today's participation will be with _____________________ (sport)? *
Have you come in close contact with anyone in the last 14 days with a diagnosis of COVID-19? *
Have you experienced a fever of at least 100.4 or higher in the last 72 hours? *
Have you experienced a cough (excluding chronic cough) in the last 72 hours? *
Have you experienced shortness of breath in the last 72 hours? *
Have you experienced a sore throat in the last 72 hours? *
What is your current temperature? Your temperature will also be taken upon arrival at practice/conditioning. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Huron Valley Schools. Report Abuse
Google Forms