YPA Athletics COVID-19 Symptoms Screening
This form is for use of daily health screening of athletes, coaches, and staff. If an individual answers YES to any of these questions, they cannot participate on that day, and cannot stay on site.
Name: First and Last *
What is your role? *
Required
Do you have a cough? *
Required
Do you have any difficulty breathing? *
Required
Do you have a NEW loss of sense of smell or taste? *
Required
Do you have a sore throat? *
Required
Have you had any recent diarrhea or vomiting? *
Required
Have you had any contact with a person known to be infected with COVID-19 within the last 14 days? *
Required
Do you have a compromised immune system or chronic disease? *
Required
Have you had a fever of 100.4 or higher in the past 72 hours? *
Required
Current Temperature: If temperature is greater than 100.4, send student/staff home *
If you answered YES to any of the above questions: please provide a description of why you answered yes.
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