PRE-WORKOUT ENTRY COVID-19

PRE-WORKOUT ENTRY COVID-19 SCREENING QUESTIONNAIRE
Full Name*

First NameLast Name
Date

MonthDayYear
Date
Temperature:
Are you experiencing any of the following symptoms? Check all that apply.
FeverFatigueCoughSneezingMuscle Aches and PainsSore ThroatDiarrheaHeadachesShortness of Breath or Difficulty BreathingNew Loss of Smell and/or TasteChillsNone of the Above/Healthy as a Horse!
YesNo
YesNo
YesNo
If you answered "Yes" to any of the above questions or are experiencing any symptoms, we strongly recommend that you participate in our virtual options.
Signature of Member/Parent/ Guardian:

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PRE-WORKOUT ENTRY COVID-19 SCREENING QUESTIONNAIRE