Winter 2020 Covid-19 Health Screening
All coaches, trainers, and parents or guardians, on behalf of players, must complete this health screening one hour prior to any LBA organized or sponsored activity. This includes but is not limited to training, practices, games, and tournaments. Upon arrival at activity, coaches will review questions and answers with each player. If any answer is yes or temperature is 100.4 or higher, coach, trainer, or player should not attend activity and will be sent home immediately. Coaches, trainers, and players will need to follow all CDC recommendations for return to play.
Email address *
Date *
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Coach, Trainer, or Player Name *
Team Name (or Coaches Name) *
Was temperature taken no more than one hour prior to arriving at activity? *
What was temperature? *
Does coach, trainer, or player feel warm to touch or have a sense of fever? *
Does coach, trainer, or player have chills? *
Is coach, trainer, or player experiencing a shortness of breath or having trouble breathing? *
Does coach, trainer, or player have a new or dry cough? *
Does coach, trainer, or player have a sore throat? *
Does coach, trainer, or player have a headache? *
Does coach, trainer, or player have explained muscle aches or pains? *
Has coach, trainer, or player recently lost or had reduction in sense of smell or taste? *
Has coach, trainer, or player experienced any of these symptoms in the last 10 days? *
Has coach, trainer, or player been in contact with someone who has tested positive or is presumed positive for Covid-19 in the last 10 days? *
Has coach, trainer, or player been tested for Covid-19 in the last 10 days? *
A copy of your responses will be emailed to the address you provided.
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