PLSD COVID-19 Symptom Sheet- PHSN Band
Please fill out the following form with a parent/guardian the same day of and prior to participation in band. If you have answered yes to any questions or your temperature is 100.0 or above, you must stay at home. The student must be fever free for 24 hours without medication prior to returning.
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Student Last Name *
Student First Name *
What section are you in? *
Student birthday *
Grade for 2020-2021 School year *
Temperature (in degrees Farenheit) *
Do you have a fever? If your temperature is at 100.0 and below please answer no. *
Do you have chills? *
Do you have a loss of sense of smell or taste? *
Do you have a cough? *
Do you have a sore throat? *
Do you have shortness of breath? *
Have you been within 6ft, without a mask, for 15 minutes with someone who is positive for COVID-19? This would be an exposure. *
Have you traveled to a "hot spot" since your last survey? If you answer yes, please monitor yourself for symptoms. You may want to get tested. The 14 day quarantine is not mandatory. You may resume normal sport activity. *
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