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PSP/PSPT Daily Covid-19 Questionnaire
*
Indicates required field
Name
*
Cell Phone Number
*
Do you currently have a fever of 100.4 or higher? (if yes, please inform the PSPT staff)
*
Yes
No
Temperature
*
Have you experienced any of the following symptoms in the past 48 hours? (if yes, please inform the PSPT staff)
*
Yes
No
Fever or Chills
Cough
Fatigue
Muscle and/or Body Aches
Headache
New Loss of Taste or Smell
Sore Throat
Congestion and/or Runny Nose
Nausea and/or Vomiting
Diarrhea
In the past 14 days,have you been in close contact (within 6-10 feet) with anyone who has been recently diagnosed, tested or quarantined for COVID-19? (if yes, please inform the PSPT staff)
*
Yes
No
Are you currently waiting on the results of a COVID-19 test? (if yes, please inform the PSPT staff)
*
Yes
No
Have you traveled out of state in the past 14 days? (If yes, Please inform the PSPT Staff)
*
Yes
No
Submit
Home
Services
Sports Performance
>
Evaluations
SP Training Plans
SP Training Schedule
Remote Training
Adult Fitness
>
AF Training Options
AF Training Schedule
Olympic Weightlifting
PSP-At-Home
Precision Health
Physical Therapy
Massage Therapy
Concussion Treatment
News & Events
Upcoming Events
PSP In The News
Blog
About
Staff
Facility
Internship Program
Referral Program
Contact
