TI Health Screening Form
In the last 14 days has anyone in your household been in contact with someone who has tested positive for COVID-19?
In the last 48 hours have you experienced any of the following symptoms?
Fever of 100.0 or greater
Fatigue, muscle, or body aches
Runny nose, or congestion
Nausea, vomiting, or diarrhea
Loss of taste or smell
Shortness of breath
In the last 10 days has anyone in your household spent more than 24 hours in a state which does not share a border with New York State?
Are you a _________________?
Home Team Parent
Away Team Parent
Athlete you are here for ________________________.
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This form was created inside of Thousand Islands CSD.