Screening Questionaire - Hoop Lab

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Home
About
- Leadership
Team Carolina Travel Team (Fall)
Fall Weekly Skill Sessions
Fall Training Season
Sunday Skill Classes
Team Carolina Showcase
Southeast Elite Girls Exposure Combine
Hoop B&B/Day Trials
Individual/Group Training
Bahamas Tour
Dynamic Moves & Finishes
Hoop Lab Full Membership
Vertiskills
Membership
- contact form
Gallery
Hoop-Blog
Giving
Hoop Lab Podcast
Mayland Survey
Bahamas Interest Survey
Tryout Check In
TC Contact List Form
Labor Day BootCamp

screening

Screen Test

* Indicates required field

Name *

First

Last

Email *

Have you been in contact with anyone that has been diagnosed or is being monitored by the CDC for COVID-19 in the last 30 days? *

Yes No

Traveled out of the country in the last 30 days? *

Yes No

Have you traveled on a cruise ship in the last 30 days? *

Yes No

Are you / they currently experiencing any of the following symptons?

Fever (greater than 100.4 degrees Fahrenheit *

Yes No

Severe Headache *

Yes No

Muscle Pain/Weakness *

Yes No

Diarrhea/Vomiting/Abdominal Pain *

Yes No

Respiratory Symptoms/ Shortness of Breath *

Yes No

Rash/Skin Irritation *

Yes No

Submit

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