RYSI Tackle Football Pre-Practice Screening Survey - COACHES/VOLUNTEERS
We are looking forward to tackle football practice tonight! We are screening all players,coaches and volunteers each day prior to practice. This screening is being done out of abundance of caution for your health as well as the health of our team.
Today's Date *
MM
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DD
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YYYY
Volunteer last name *
Volunteer's First Initial Only *
Team (10U,12U,14U) *
If you or anyone in your home has tested positive for COVID-19, has it been more than 14 days since the symptoms resolved?
Clear selection
In the last 14 days, have you been in close contact with anyone who has COVID-19 or who is having COVID-19 symptoms? *
Do you have a cough, shortness of breath or difficulty breathing? *
Do you have a sore throat, runny or stuffy nose? *
Do you have seasonal allergies? *
Have you experienced a recent loss of taste or smell? *
Do you have any other flu-like symptoms such as GI upset, body aches or headache? *
Please explain any "yes" answers
Name and cell of person filling out the form. *
Submit
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