DCA Athlete Health, Safety, & Stress Questionnaire
First Name *
Last Name *
Today's Date *
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Workout Session
Have you been asked to self-isolate or quarantine by a doctor or public health official in the last 24 hours?
Have you experienced any cold or flu-like symptoms in the last 24 hours (fever, cough, shortness of breath or other respiratory problems)?
Have you had close contact with or cared for someone diagnosed with COVID-19 within the last 24 hours?
Body Temperature Reading
1. Sleep Duration
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2. Sleep Quality
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3. Breakfast Quality
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4. Energy Level
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5. Personal Stress
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6. Soreness
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7. Hydration (water intake from yesterday)
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8. Urine Color (most recent)
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General Comments (Make notes of injuries, problems, specific situations, or ideas)
Injury Survey (Identify your 3 most painful body sites and rate their severity on a scale of 1 for "very slight pain" to 5)
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