Health Screening Form
Student-athlete, please fill out the following form prior to sport with parent/guardian. If you have answered yes to any questions, please stay home and follow-up with a physician. If a student-athlete's temperature is above 100.0 he or she is to stay home OR answers YES to any of the questions.
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Email *
Student-athlete name *
Today's Date *
MM
/
DD
/
YYYY
Do you have any of the following symptoms? *
Have you been in close contact or cared for someone with COVID-19? *
Have you traveled to a "hot-spot" for COVID-19? *
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