Fall FOOTBALL 2020 Cooper Self-Screening
This form must be completed every day by 12:00pm that you attend an Cooper sponsored interscholastic practice, workout, game, or event.

If ALL of the questions below are answered NO, then the student-athlete or coach may enter the workout area for today's event.

If you answer YES to ANY of the questions below, please stay home, care for yourself, and contact your health provider with any worsening symptoms.
Email address *
Today's Date *
Your First and Last Name (No Nicknames Please!) *
Please list your Jersey Number (remember Varsity is V, Bsquad is B and Freshmen is F) Your response should look like this V99 and remember this Number for daily Check in *
Do you have a NEW or WORSENING cough or shortness of breath? *
Have you had a fever or cold symptoms in the previous 24 hours? *
Do you have at least two of the following symptoms: Fever (>100), chills, muscle pain, headache, sore throat, new loss of taste or smell? *
Emergency Contact Name for TODAY - First and Last *
Emergency Contact Phone Number for TODAY *
Please list any and all allergies or medical issues we should be aware of. If none reply with NONE *
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