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* 1. Full Name (first, last)

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* 2. Team

Excluding pre-existing conditions (i.e. asthma, allergies, etc.)

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* 3. Have you had a cough in the last 24 hours

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* 4. Have you experienced shortness of breath or difficulty breathing?

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* 5. Have you had close contact with anyone with COVID-19 or been to a "hot spot" for COVID-19?

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* 6. Have you experienced any of the following (select all that apply)?

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* 7. Temperature (take prior to arriving to MHS)

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