Covid-19 Exposure Questionnaire

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Athlete's Full Name *

Austin Skyline Team Name *

Parent's Name filling out this questionnaire *

Parent's cell phone number *

Date of Covid-19 Exposure and approximate time of day *

YYYY

Have you attended a practice or tournament without knowledge to exposure until after the fact? *

Yes

If you answered yes, please share in detail what function you attended for Skyline. Please include dates, times, and any specific details to help us understand the timing and who you were around during this time.

Did you keep your mask on the entire time during the Skyline event?

Yes

Does not apply to me because I didn't attend a Skyline event

Clear selection

Did a teammate or coach ride in the car with you at anytime to or from the Skyline function or even outside of a Skyline event? *

Yes

If you answered yes to the previous question did you have on a mask while riding in the car?

Yes

Does not apply to me because I answered no to the previous question.

Clear selection

If you answered no to the previous question: How long were you with a teammate/coach while riding in the car unmasked? Please note if the duration was more or less than 15 minutes and be specific please.

You do understand that if you are asked to quarantine you may wait 4 full days since the exposure before taking a test of any kind for Covid-19. Send all results to Jenny Luke and Jenny Phillips. If your test results are negative. Upon receiving your results a Director will contact you for the next steps. Please note: You must get approval prior to returning to practice or any Skyline event. *

Yes, I understand

No, I do not understand and will need clarification

Submit

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