COVID-19 Screening
At-home screening to be performed and recorded daily prior to entering any sports medicine facility.
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Email *
Last name, First name, Grade
Sport
Have you been diagnosed with COVID-19? *
Are you, or someone in your household, pending a covid-19 test? *
Have you experienced symptoms of COVID-19? *
Have you had close contact, or cared for someone with COVID-19? *
Do you have a fever? *
Do you have a cough? *
Do you have a sore throat? *
Are you experiencing shortness of breath? *
Are you experiencing a loss of taste or smell? *
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