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COVID Self-Reporting Survey
1.
(First, Last) Name
*
2.
What team are you on?
(Required.)
3.
Do you have any of the following symptoms: Fever, chills, dry cough, difficulty breathing, respiratory illness, or acute loss of taste or smell?
Yes
No
4.
Have you tested positive for Covid-19 in the past two weeks?
Yes
No
5.
Have you informed your team of your Covid-19 results?
Yes
No [We will inform your team if you choose this option]
Current Progress,
0 of 5 answered