Baseball Symptom Pre-Screening Form

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Each athlete should complete and submit this form at least 30 minutes prior to the scheduled start of their team activity each day. (Team activities include practice, bus departure time for an away contest, or schedule warm-up time for a home contests) Students who are unable to complete this electronic version on any day will need to complete the in-person pre-screening with their coach before beginning team activities.

Email *

Athlete Last Name *

Athlete First Name *

Your Role *

Grade *

Level *

Date *

YYYY

Do you have any of the following symptoms? (new uncontrolled cough that causes difficulty breathing, unexplained muscle pain, unexplained chills, unexplained nausea, vomiting or diarrhea, new loss of taste or smell, unexplained shortness of breath or difficulty breathing, unexplained sore throat, or a temperature over 100.4F) *

Yes

Have you had close contact with someone diagnosed with COVID since your last team activity or has the health department or a health care provider advised you to quarantine? Have you been diagnosed with COVID since your last practice? *

Yes

I understand that if I answered yes to any of the questions above that I should not attend today's team activity. *

Yes

Send me a copy of my responses.

Submit

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