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COVID 19 Health Self Assessment
Please complete this form prior to entering any RSU 35 building. If you answer "yes" to any of the questions below, you are required to not come in.
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Email
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Your email
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Your answer
8/4/2020
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School
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Do you have new onset of any of the following symptoms of COVID- 19? Symptoms related to chronic illness do not need to be reported.
Yes
No
Fever or chill
Temperature over 100F
Cough
Shortness of Breath
Fatigue
Muscle or Body Aches
Headaches
New Lose of Taste or Smell
Sore Throat
Congestion or Runny Nose
Nausea or Vomiting
Diarrhea
Have you had close contact with someone who is positive for COVID within the past 14 days
Have you tested positive for COVID-19 in the past 10 days
Have you traveled out of state (non-routine) in the past 14 days
Yes
No
Fever or chill
Temperature over 100F
Cough
Shortness of Breath
Fatigue
Muscle or Body Aches
Headaches
New Lose of Taste or Smell
Sore Throat
Congestion or Runny Nose
Nausea or Vomiting
Diarrhea
Have you had close contact with someone who is positive for COVID within the past 14 days
Have you tested positive for COVID-19 in the past 10 days
Have you traveled out of state (non-routine) in the past 14 days
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