PSTC: COVID-19 Screening Survey 4 Star Tennis Academy at Potomac Swim & Tennis Club Question Title * 1. Camper's Name First Name Last Name Question Title * 2. Parent/Guardian Name First Name Last Name Question Title * 3. Have you or your child been around anyone who has been sick within the last 14 days (cough, fever, sinus issue, sore throat, diarrhea, vomiting, loss of taste/smell, flu like symptoms etc)? Yes No Question Title * 4. Have you or your child been with anyone in the last 14 days who has been tested for COVID19, diagnosed with COVID19, or is under evaluation for COVID19 at this time? Yes No Question Title * 5. Do you or your child currently have any of the following symptoms? Muscle pain (not exercise-related) Cough Shortness of breath Chest pain Feeling feverish/chills New loss of smell or taste Gastrointestinal symptoms (nausea, vomiting and/or diarrhea) Sinus or cold-like symptoms (headache, congestion/runny nose, sore throat). Fever (temperature > 99.5°F or > 37.5°C) Question Title * 6. Please check your child's current temperature and record in Fahrenheit here: *If your child has a temperature over 99.5 or you have answered yes to any of the questions above, please keep your child home and contact their pediatrician. Also email us a letter from their pediatrician before they can return to camp. Question Title * 7. Additional Information SUBMIT
