COVID Questionnaire

Your Name *

Your Email *

Select Your Team and Level *
Make Selection18U AA16U AA16U A National14U A National14U B National12U AA12U A National12U B National12U B American10U AA10U B National10U B American8U White8U Black8U Red6U

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Have you experienced a fever of 100.4 or greater in the past 14 days? *
YesNo

Have you received a positive result from a COVID-19 test within the past 14 days? *
YesNo

Have you been in contact with anyone while they had COVID-19 or symptoms of COVID-19 in the past 14 days? *
YesNo

In the past 14 days, have you, or someone you have been in contact with, traveled outside your state or country to an area with restrictions due to COVID-19? *
YesNo

In the past 14 days, have you experienced any of the following new symptoms attributed to another health condition? Select all that apply. *
CoughLoss of smell or tasteRunny noseShortness of breathSore throatNone of these

Please leave this field empty.