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Lone Star Health Screening [Winter Practice 3/7]
Please complete this health screening questionnaire within 24 hours of practice. IMPORTANT : If you answer YES to any questions, please sit out practice for a week.
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* Indicates required question
Email
*
Your email
Player First Name
*
Your answer
Player Last Name
*
Your answer
*
NO
YES
In the last 14 days, have you been in close contact with someone who is confirmed to have COVID-19?
Have you felt feverish in the past 24 hours or had a measured temperature of 100.4 degrees F or higher?
NO
YES
In the last 14 days, have you been in close contact with someone who is confirmed to have COVID-19?
Have you felt feverish in the past 24 hours or had a measured temperature of 100.4 degrees F or higher?
Have you experienced any of these symptoms within the past 24 hours:
*
NO
YES
New or worsening cough
Shortness of breath or difficulty breathing
Fatigue
Chills
Muscle or body aches (not caused by a specific activity, e.g. physical exercise)
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea, vomiting, or diarrhea
NO
YES
New or worsening cough
Shortness of breath or difficulty breathing
Fatigue
Chills
Muscle or body aches (not caused by a specific activity, e.g. physical exercise)
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea, vomiting, or diarrhea
A copy of your responses will be emailed to the address you provided.
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