Wellness Check

* Indicates required field

Name *

First

Last

List today's date: *

What was your specific temperature (include the decimal)? *

Approximately what time was your temperature taken? *

Select any of the symptoms / situations that you have experienced in the past 48 hours. If you select any option other than the last option, you must notify your coach IMMEDIATELY: *

Fever, cough, chills, and / or muscle aches Sore throat, runny nose, and / or loss of taste or smell Nausea, vomiting, and / or diarrhea Shortness of breath and / or headache Close contact or cared for someone with COVID-19 I have NOT experienced any of the symptoms / situations listed above in the past 48 hours

Submit