BDHS Athletics COVID-19 SELF ASSESSMENT FORM
Please fill this out within 24 hours of your return to Athletics for your first practice or after an extended break.
Track and Field
Have you had a temperature of over 100.4℉ in the last 24 hours?
Have you had any of the following symptoms in the last 24 hours? If not, answer "No".
Difficulty breathing/Shortness of breath
Muscle or body aches
New loss of taste or smell
Congestion or runny nose
Nausea or vomiting
Have you traveled outside of the country within the past 14 days?
Have you been in close contact with anyone known or suspected to have the COVID-19 coronavirus illness in the last 14 days?
I CERTIFY THAT THE ABOVE ANSWERS ARE TRUE, ACCURATE, AND COMPLETE. I ALSO CERTIFY THAT IF AT ANY POINT, I CAN ANSWER YES TO ANY OF THE ABOVE QUESTIONS, I WILL IMMEDIATELY NOTIFY A COACH OR ADMINISTRATOR AND WILL STAY HOME UNTIL I CAN ANSWER NO TO ALL OF THE ABOVE QUESTIONS. I acknowledge the above
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Bishop Garcia Diego HS.