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Injury Screening for Athletic Trainers
This form is to be done every day before the screening process at athletics
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* Indicates required question
Email
*
Your email
Your Name? (Student-athlete attending athletics)
*
Your answer
What sport do you play?
*
Your answer
Name and Phone Number of your Guardian?
*
Your answer
Have you recently traveled outside of the County of Gregg to an area with known local spread of COVID-19?
*
1 point
YES
NO
Have you come into close contact (within 6 feet) with someone who has a laboratory-confirmed COVID-19 diagnosis in the past 14 days?
*
1 point
Yes
NO
If you answered yes to the previous question, does the person that tested positive live in your household?
Yes
No
Clear selection
What date did they become infected?
MM
/
DD
/
YYYY
Do you have a fever (greater than 100.4*F), Diarrhea, OR symptoms of lower respiratory illness such as cough, shortness of breath, difficulty breathing, or sore throat?
*
1 point
NO
Yes
If you have an injury/illness that you would like to let the athletic training staff or coaches know, please answer here AND let your coach know in person.
Your answer
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