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Track Covid-19 Pre-Practice Screening
Everyone attending practice or a Doherty Track & Field activity or event, must complete this within 30 minutes of attending that practice, activity, or event
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* Indicates required question
Your last name then first (Example: Smith, John)
*
Your answer
Do you have a temperature over 100.4 F?
Yes
No
Clear selection
Do you have a new shortness of breath that you cannot attribute to another health condition?
*
Yes
No
A new dry cough that you cannot attribute to another health condition?
*
Yes
No
Do you have new body aches that you cannot attribute to another health condition or a specific activity such as physical exercise?
*
Yes
No
Do you have a new sore throat that you cannot attribute to another health condition?
*
Yes
No
Do you have nausea, vomiting or diarrhea that you cannot attribute to another health condition?
*
Yes
No
Do you have a new loss of taste or smell that you cannot attribute to another health condition
*
Yes
No
Have you or anyone in your house tested positive for Covid-19 within the last 14 days?
*
Yes
No
Are you or anyone in your house awaiting Covid-19 test results?
*
Yes
No
Have you been exposed to anyone (within 6 feet for more than 15 minutes) that has tested positive for Covid-19 within the last 14 days?
*
Yes
No
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