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Winter Cheering Daily Screening Form
Student-athletes and Coaches: This screening form needs to be submitted by 1pm everyday prior to practice or competition.
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* Indicates required question
Student-Athlete or Coach Email Address
*
Your answer
Todays Date
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MM
/
DD
/
YYYY
Student-Athlete or Coach Full Name
*
Your answer
Day of the week
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
Please complete this short checklist by 1pm everyday prior to practice or competition. (Check all that apply)
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Temperature 100.4 degrees Farenheit or higher when taken by mouth.
Sore Throat.
New uncontrolled cough that causes difficulty breathing (for students with chronic allergic/asthmatic cough, a change in their cough from baseline).
Diarrhea, vomiting or abdominal pain.
New onset of severe headache, especially with a fever.
None of the above
Required
Close Contact/Potential Exposure
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Had close contact (within 6 feet of an infected person for at least 15 minutes) with a person with confirmed COVID-19.
Traveled to or lived in an area where the Local, Tribal, Territorial or State Health Department is reporting large numbers of COVID-19 cases as described in the Community Mitigation Framework.
Live in areas with high community transmission (as described in the Community Litigation Framework) while the school remains open.
None of the above.
Required
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