BC Band Health Screen

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Please read this list of symptoms:
* Feeling feverish or a measured temperature greater than or equal to 100.0 degrees Fahrenheit
* Loss of taste or smell
* Cough
* Difficulty breathing
* Shortness of breath
* Headache
* Chills
* Sore throat
* Shaking or exaggerated shivering
* Significant muscle pain or ache
* Diarrhea

Have you recently begun experiencing any of the symptoms listed above in a way that is not normal for you? *

Yes

What is your temperature? *

First name *

Last name *

Instrument *

Flute

Clarinet

Bass Clarinet

Alto Saxophone

Tenor Saxophone

Bari Saxophone

Trumpet

French Horn

Trombone

Baritone

Tuba

Percussion

After the first three weeks of virtual school, do you plan on remaining virtual or will you be attending in person school? *

Attend In Person School

Remain in Virtual School

Student Phone Number *

Student Email address *

Parent First and Last Name *

Parent Phone Number *

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