COVID-19 Athlete Self-Check Form
The Woodstock Dolphins Coaches and Board of Directors are dedicated to ensuring the safety of all of our athletes and families. As such, during the COVID-19 pandemic it is important to understand when your swimmer should not be coming into practice. This form will be used to assess your swimmer's health daily to determine his/her ability to safely continue practicing.
Name* (Last, First)
Contact* (Phone or Email)
Swimmer practice level
Please answer yes or no if your swimmer(s) have had any combination of the following symptoms: Fever (100.4 or higher), dry consistent cough, shortness of breath/difficulty breathing, congestion/runny nose, diarrhea (not due to a preexisting condition), muscle pain, repeated shaking or chills, sore throat, loss of sense of taste or smell, unusual continuous headache lasting for more than 48 hours,
In the past 14 days, have you been in close physical contact, sustained communication face-to-face for 2-3 minutes or direct physical contact, within 6 feet for 2-3 minutes with someone displaying any of the following COVID-19 symptoms? Fever (100.4 or higher), Dry Consistent Cough, Shortness of breath / difficulty breathing, Congestion or runny nose, Diarrhea, Muscle pain / repeated shaking with chills, Sore throat / loss of sense of taste and/or smell?
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