Activities & Athletics COVID-19 Health Screening
Email Address *
Today's Date *
MM
/
DD
/
YYYY
Time *
Time
:
Last Name *
First Name *
Student Pod # *
Temperature Screening *
Required
Do you have a new or worsening cough or shortness of breath/difficulty breathing? *
Do you have at least two of the following symptoms: chills, fatigue, muscle pain, headache, sore throat, new loss of taste or smell, or diarrhea? *
Submit
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy