AWDC Girl Ready Assessment

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Must be completed 30 min prior to start of camp

Camper's Full name and unit *

Name of the person completing the form *

Today's date *

YYYY

In the last 72 hours have you/your Girl Scout experienced ANY of the following new symptoms that cannot be attributed to another health condition or specific activity such as physical exercise?

If any answer is Yes to ANY of these questions, the camper should stay home and seek evaluation by their healthcare provider.

Do you have a fever? *

Yes

Do you have a cough? *

Yes

Do you have shortness of breath? *

Yes

Are you experiencing fatigue? *

Yes

Do you have muscle aches? *

Yes

Are you experiencing any other flu-like symptoms, such as gastrointestinal upset or headaches? *

Yes

Are you experiencing new loss of taste or smell? *

Yes

Do you have a temperature over 100F? *

Yes

Have you had contact with any confirmed COVID-19 positive patients in the last 14 days? *

Yes

Have you traveled outside of Washington State in the last 2 weeks? *

Yes

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