COVID-19 Screening Questions
Please fill out this form before practices and games for athletic participation on school grounds.
If you answer YES to any of the questions/symptoms, PLEASE TELL YOUR COACH WHEN YOU GET TO TRAINING OR DON'T REPORT TO TRAINING AND NOTIFY COACH FOR FURTHER INSTRUCTIONS. YOU ARE NOT TO PARTICIPATE IF YOU ARE SYMPTOMATIC.
Name (Last, First)
Out of Season/Other/Weightlifting
Coach or other team personnel
Student/College Athletic Training Aide
Middle School Boys Basketball
Middle School Girls Basketball
Middle School Wrestling
Middle School Cheer
Middle School Baseball
Middle School Softball
Middle School Track
Middle School Boys Volleyball
Have you had an unexplained cough in the last 24 hours?
Are you short of breath or having unexplained difficulty breathing?
Have you had close contact with anyone with COVID19 or been to a "hot spot" for COVID19?
Are you experiencing any symptoms related to COVID19?
New Loss of Taste
New Loss of Smell
Have you had a fever (>100.4) in the last 24 hours?
Never submit passwords through Google Forms.
This form was created inside of Beavercreek City Schools.