Athlete/Coach Daily COVID-19 Screening Form
Note: This is not meant to take the place of consultation with your health care provider or to diagnose or treat conditions.
Student's First Name
Student's Last Name
Family Cell Phone Number
Which group is the student training with at the US Hunting Valley campus?
American Flyers Diving
Ohio Elite Baseball
In the last 24 hours, the student: (please check any that apply)
Developed a new cough
Has a sore throat
Is experiencing shortness of breath or trouble breathing
Developed a headache
Developed body aches or muscle pain
Developed a runny nose, stuffy nose, or sneezing unrelated to allergies
Has lost the sense of taste and/or smell
Has developed nausea, vomiting, or diarrhea
Has recorded a fever of 100.0 or higher
Has been in close contact with someone with a confirmed case or suspected case of COVID-19 in the past 14 days
The student is showing no signs of COVID-19.
I'm not sure
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This form was created inside of University School.