Cox Mill Band Daily Monitoring
This form must be completed BEFORE each practice.
Name (First and Last) *
Section *
Recently have you experienced Racing, fluttering, or Skipping Beats of Heart *
Recently have you experienced unusual Dizziness During or After Exercise *
Recently have you experienced cough or shortness of breath *
Recently have you experienced Sore Throat *
Recently have you experienced New loss of taste or smell *
Recently have you experienced Diarrhea or Vomiting *
Recently have you experienced Fever *
Recently have you experienced Temperature Greater than 100.4º F *
Recently has a Household Member been diagnosed with COVID-19 or have symptoms? *
Recently have you come in Close Contact with someone with COVID-19 *
Temperature reading today: *
Submit
Never submit passwords through Google Forms.
This form was created inside of Cabarrus County Schools. Report Abuse