In response to the COVID-19 pandemic and in order to ensure a safe and healthy environment for our school community, Joint Guidance from the Illinois State Board of Education and the Illinois Department of Public Health requires that every student undergo a daily symptom screening prior to utilizing School District transportation or entering any School District building.
 
A daily symptom screening must be completed by parents of Worth 127 students each morning.  Those students who have not been screened by a parent will be unable to attend school.  By sending your child to school, you are verifying that they have been screened.
 
This form must be signed and returned to the School District prior to January 1st, 2021.  

Certification and Verification of Daily Symptom Screening:
 
I certify that prior to utilizing District transportation and/or entering a District building, my child(ren) will receive a daily symptom screening at home by an adult caregiver to determine if my student is experiencing any of the following COVID-19 symptoms:
Temperature of 100.4 (or greater) degrees Fahrenheit/38 degrees Celsius; Cough; Shortness of breath or difficulty breathing; Chills; Fatigue; Muscle and body aches; Headache; Sore throat;  New loss of taste or smell; Congestion or runny nose; Nausea and/or vomiting; Diarrhea; or any other COVID-19 symptoms identified by the CDC or IDPH.  
By sending my student on District transportation and/or to school on any given day, I have verified that my child has received a daily symptom screening and is not experiencing any COVID-19 symptoms.  
If my child is experiencing any of the above symptoms at the time of the daily screening, I will notify the school in writing of my student’s absence by sending an email to the school office and indicating the above symptoms that my student is experiencing.  Please also call in to the attendance line at the school.   If District staff contacts me to gather additional information related to the results of my student’s daily screening, I will provide the necessary information as requested.  
 
Certification and Verification of Other COVID-19 Related Exposures:
 
I will notify the school that my student will be absent pending further direction from the District if: (1) my student receives a diagnosis of COVID-19; (2) my student is suspected of having COVID-19; (3) my student comes in close contact with an individual who tested positive for COVID-19 or is suspected of having COVID-19. If District staff contacts me to gather additional information related to the reason(s) for my student’s absence, I will provide the necessary information as requested.

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A form will need to be filled out for each student in your household. There is a separate form for each school, so please fill out the proper school's form for each student.

This form is your agreement to follow the self certification every day for January.  A new form will be made available as we get closer to February.