School COVID-19 Monitoring Form

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School COVID-19 Monitoring Form - HS Cross Country

Correo electrónico *

Name *

Have you had a new or unusual cough in the last 24 hours? *

Yes

Have you had a score throat in the last 24 hours? *

Yes

Have you had a shortness of breath in the last 24 hours? *

Yes

Have you had a fever of 100.3 or higher in the last 24 hours? *

Yes

Have you had close contact or cared for someone with a confirmed case of COVID-19 in the last 24 hours? *

Yes

Emergency Contact (Name) *

Emergency Contact (phone number) *

Se enviará un correo electrónico con una copia de tus respuestas a la dirección que suministraste.

Enviar

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El formulario se creó en Our Lady of the Lakes School. Denunciar abuso