MYS Illness Report 2020-2021
Player Name (First and Last) *
Team Name (i.e. 2004 Girls Green) *
Person Completing the Form *
Email of Person Completing Form *
Player or Parent Email Address (if different than above)
Date of onset of Illness *
MM
/
DD
/
YYYY
Who is ill? *
Main symptoms experienced *
Has ill person been tested for COVID-19 or been exposed to anyone who has tested positive for COVID-19? (click on all that are applicable) *
Required
Has a player in this household been to a practice, scrimmage or game in the last 14 days? *
What is the date of the most recent practice, scrimmage or game attended in last 14 days? *
MM
/
DD
/
YYYY
Has the coach been notified of illness? *
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