2021 Spring RALL COVID Screening Form
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Email *
Parent Contact Number *
Parent First Name *
Parent Last Name *
Player First Name *
Player Last Name *
Have you or your players experienced any of the following symptoms in the past 48 hours? - Fever or chills- Cough- Shortness of breath or difficulty breathing- Muscle or body aches- Headache- New loss of taste or smell- Sore throat- Congestion or runny nose- Nausea or vomiting- Diarrhea *
Within the past 14 days, have you or your player been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have a confirmed case of COVID-19 or with anyone who has any symptoms consistent with COVID-19? *
Are you or your player isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19? *
Are you or your player currently waiting on the results of a COVID-19 test? *
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