Daily COVID-19 Questionnaire for Monrovia Athletics - HS Boys Track
Monrovia High School & Middle School Daily Pre-Screening
* Required
Last Name
*
Your answer
First Name
*
Your answer
Grade Level
*
12
11
10
9
Other:
Sport
*
HS Boys Track
Other:
Required
COVID-19 Questionnaire
Please answer the following questions, regarding any COVID-19 symptoms as accurately as possible.
Have you had a cough or sore throat in the last 24 hours?
*
No
Yes
Have you had any shortness of breath or difficulty breathing recently?
*
No
Yes
Have you had a fever of 100° F or higher, in the last 10 days?
*
No
Yes
Have you had close contact or cared for anyone who has tested positive for COVID-19, in the last 10 days?
*
No
Yes
Have you experienced any other symptoms associated with COVID-19 in the last 24 hours? (Unexplained Muscle Pain, Unexplained Headaches, a Loss of Taste/Smell, Chills or Fatigue?)
*
No
Yes
Submit
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