MSHS Daily Family Covid-19 Screening Form

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This form MUST be completed each school day. One form is completed for the entire school family. If you answer YES to any of the questions, your child/children may not come to school. This form is considered your notification to school and you don't have to call us to report their absence.

Last Name *

2. Does your child/children have a fever over 100.4 F? *

Yes

3. Has your child/children been in close contact in the past 14 days with anyone diagnosed with Covid-19? *

Yes

4. Is there anyone in your home showing any of the following symptoms: fever or chills, cough, headache, muscle aches, nausea, vomiting or diarrhea, new loss of taste or smell, NEW runny nose or congestion, shortness of breath or difficulty breathing, or a sore throat?

Yes

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