COVID-19 Daily Pre-Screening Questions - Boys Basketball
* Required
Email address
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Your email
Name of Athlete
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Your answer
Parent/Guardian Filling out this Form
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Your answer
Are you experiencing any of the following symptoms?
1.Fever (≥ 100.4°F)
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Yes
No
2.Cough or shortness of breath
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Yes
No
3.Sore Throat
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Yes
No
4.Chills
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Yes
No
5.Muscle aches or rigors
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Yes
No
6.Headache
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Yes
No
7.New loss of taste or smell
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Yes
No
8.Abdominal pain, nausea, vomiting or diarrhea
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Yes
No
Have you had close contact with someone who is currently sick?
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Yes
No
Is someone in your household diagnosed with or being tested for Covid-19?
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Yes
No
Have you been diagnosed with COVID-19 in the past three weeks or have reason to believe you have COVID-19?
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Yes
No
Have you traveled or had close contact with anyone who has traveled internationally in the last 14 days?
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Yes
No
Confirm that this participant does not have Covid-19 related symptoms and has not had close contact / potential exposure to someone sick.
*
Okay to participate today.
Not Okay to participate today.
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