Daily COVID-19 Questionnaire for Monrovia Athletics - MS Wrestling
Monrovia High School & Middle School Daily Pre-Screening
Last Name *
First Name *
Grade Level *
Sport *
Required
Who was your practice sparring partner at your last practice? *
COVID-19 Questionnaire
Please answer the following questions, regarding any COVID-19 symptoms as accurately as possible.
Have you had a cough or sore throat in the last 24 hours? *
Have you had any shortness of breath or difficulty breathing recently? *
Have you had a fever of 100° F or higher, in the last 10 days? *
Have you had close contact or cared for anyone who has tested positive for COVID-19, in the last 10 days? *
Have you experienced any other symptoms associated with COVID-19 in the last 24 hours? (Unexplained Muscle Pain, Unexplained Headaches, a Loss of Taste/Smell, Chills or Fatigue?) *
Submit
Never submit passwords through Google Forms.
This form was created inside of Monroe-Gregg School District. Report Abuse