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Summer PAC COVID-19 Daily Questions
This form should be completed daily by Camp Staff and Participants
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* Indicates required question
Participant Name
*
Your answer
Have you had ANY contact with a person who is/was positive for COVID - 19?
*
Yes
No
Have you had a new or worsening cough OR shortness of breath/difficulty breathing?
*
Yes
No
Have you had a temperature above 98.6?
*
Yes
No
Have you experienced two or more of the following symptoms? Check All that Apply
*
Chills
Repeated shaking with chills
Muscle Pain
Headache
Shortness of Breath
Sore Throat
NEW loss of Taste
New Loss of Smell
Diarrhea
NONE
Required
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