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COVID-19 Screener
If the answer is yeas to any of the following questions you must not come to the adaptive program this weekend.
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Email
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Your email
Name of person completing form
Your answer
Phone Number
Your answer
Name of participant if different than who is completing form
Your answer
Are you currently waiting for a Covid-19 test result or are you confirmed positive for Covid-19?
Yes
No
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Have you or your athelete experienced any of the following in the past 48 hours? *Fever or chills *CoughShortness of breath or difficulty breathing *Fatigue, Muscle or body aches *Headache *New loss of taste or smell *Sore throat *Congestion or runny nose *Nausea or vomiting *Diarrhea
Yes
No
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Do you have anyone in your household (or someone you have been in contact with) that has tested positive for Covid-19, or exhibited any fever, cough, or shortness of breath within the last 14 days?
Yes
No
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Have you or your athlete travelled internationally or from a state with widespread community transmission of COVID-19 per the New York State Travel Advisory in the past 14 days?
Yes
No
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