HVVC COVID-19 Screening tool
Players, coaches and spectators must fill out this form prior to entering the HVVC facility.
* Required
Email address
*
Your email
Athlete, Coach or Parent? I am a:
*
Player
Coach
Parent / Spectator
What team are you with?
*
Your answer
First and last name
*
Your answer
Best phone # (required for contact tracing)
*
Your answer
What is your temperature today (preferably taken at home):
*
Your answer
Check any of the symptoms below that you've experienced in the past 24 hours. Note: If you checked any of these symptoms, you may not enter the HVVC facility.
*
1 point
Fever (100.4 degrees or above)
Cough
Difficulty breathing or shortness of breath
Loss of sense of taste or smell
None of the above
Required
In the past 24 hours, have you experienced any of the symptoms below that are new or not common to you? NOTE: If you checked any TWO of the symptoms, you may not enter an HVVC facility. Players should contact their coach immediately.
*
1 point
Chills
Muscle aches
Sore throat
Diarrhea
Nausea / Vomiting / Abdominal pain
Congestion or runny nose
Excessive fatigue
Headache
None of the above
Required
In the past 14 days, have you been in close contact with anyone who tested positive for COVID-19? (Close contact = Less than 6 feet for more than 15 minutes over the course of 24 hours, with or without a mask on). If "Yes", you may not enter the HVVC facility. Players should contact their coach immediately.
*
1 point
Yes
No
I certify and confirm that the answers I have provided in this form are complete, truthful and accurate.
*
Yes
No
After submitting, check your email for a confirmation certificate to present for admission into HVVC- IF you have screened as "healthy to participate".
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