HVVC COVID-19 Screening tool

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Players, coaches and spectators must fill out this form prior to entering the HVVC facility.

Email *

Athlete, Coach or Parent? I am a: *

Player

Coach

Parent / Spectator

What team are you with? *

First and last name *

Best phone # (required for contact tracing) *

What is your temperature today (preferably taken at home): *

Check any of the symptoms below that you've experienced in the past 24 hours. Note: If you checked any of these symptoms, you may not enter the HVVC facility. *

1 point

Fever (100.4 degrees or above)

Cough

Difficulty breathing or shortness of breath

Loss of sense of taste or smell

None of the above

Required

In the past 24 hours, have you experienced any of the symptoms below that are new or not common to you? NOTE: If you checked any TWO of the symptoms, you may not enter an HVVC facility. Players should contact their coach immediately. *

1 point

Chills

Muscle aches

Sore throat

Diarrhea

Nausea / Vomiting / Abdominal pain

Congestion or runny nose

Excessive fatigue

Headache

None of the above

Required

In the past 14 days, have you been in close contact with anyone who tested positive for COVID-19? (Close contact = Less than 6 feet for more than 15 minutes over the course of 24 hours, with or without a mask on). If "Yes", you may not enter the HVVC facility. Players should contact their coach immediately. *

1 point

Yes

I certify and confirm that the answers I have provided in this form are complete, truthful and accurate. *

Yes

After submitting, check your email for a confirmation certificate to present for admission into HVVC- IF you have screened as "healthy to participate".

Submit

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