Revised Daily COVID-19 Daily Pre-screening Questionnaire (fill out by 2pm day of practice or game)
Any of the symptoms below could indicate a COVID-19 infection and may put you at risk for spreading illness to others. Please note that this list does not include all possible symptoms and anyone with COVID-19 may experience any, all, or none of these symptoms. Please check if you have any of the Symptoms from SECTION 1 or Close Contact/Potential Exposure from SECTION 2:
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Email *
First Name *
Last Name *
SPORT *
SECTION 1:  SYMPTOMS
Students who are sick (e.g. fever, vomiting, diarrhea) should not attend practice or a game if TWO OR MORE of the fields in Column A are checked off OR AT LEAST ONE field in column B is checked off.  Please stay home, and let your Coach know.
COLUMN A:  Please check if you have any of the following symptoms: *
Required
COLUMN B:  Please check if you have any of the following symptoms: *
Required
SECTION 2:  CLOSE CONTACT/POTENTIAL EXPOSURE
If ANY of the fields in Section 2 are checked off, you should remain home for 14 days from the last date of exposure .
Please verify if in the last 14 days: *
Required
A copy of your responses will be emailed to the address you provided.
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