COVID-19 Symptom Sheet- boys basketball
Student-athlete, please fill out the following form prior to sport with parent/guardian. If you have answered yes to any questions, please stay home and follow-up with a physician. If a student-athlete's temperature is above 100.0 he or she is to stay home OR answers YES to any of the questions.
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Student-athlete name *
Student-athlete birthday *
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DD
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Grade for 2020-2021 School year *
Temperature (in degrees Fahrenheit) *
Do you have a fever? *
Do you have chills? *
Do you have loss of sense of smell or taste? *
Do you have a cough? *
Do you have a sore throat? *
Do you have shortness of breath? *
Have you been in close contact or cared for someone with COVID-19? *
Have you traveled out of town since your last survey? If you answer yes, you must report to your head coach or athletic trainer and give the date(s) and location of the trip. You are no longer required to self quarantine for 14 days, however, monitor your health and if you develop any symptoms you should contact your coach immediately. Otherwise, return to play as normal. *
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