Health Screening Form-Video Game Tournament Youth Health Screening Form - Video Game Tournament Name* First Last Are you experiencing the following symptoms: Fever (including chills/sweats) and/or cough (new or worsening)?*YesNoAre you experiencing TWO or more of the following symptoms: Shortness of breath | Loss of smell or taste | Sore throat or difficulty swallowing | Headache | Unusual fatigue or lack of energy | Muscle aches | Loss of appetite | Vomiting or diarrhea for more than 24 hours | Runny, stuffy or congested nose (not related to seasonal allergies, or conditions).*YesNoHave you travelled outside of Newfoundland & Labrador in the past 14 days?*YesNoHave you travelled outside of Newfoundland & Labrador in the past 14 days?*YesNoHave you had close contact with a person who has travelled outside the province and has been sick in the past 14 days?*YesNoHave you had close contact with a person who has been confirmed or suspected to be a case of COVID-19 in the past 14 days.*YesNo
