Covid

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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

Location

50 Williams Parkway
Unit D
East Hanover, NJ 07936

Telephone

(973) 585-6008

Email

info@precisionsportsperformance.com

Home
Services
Precision Health
News & Events
About
Contact