Required Student Daily Health Check: English

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1. In order to support safe return to school and contact tracing. Please fill this form out each day for your child(ren). If you do not complete this form, a staff member will call to support your participation in this protocol.

2. The Student Daily Health Check DOES NOT take the place of an attendance call to the school to report your child's absence

Email *

Parent: First & Last Name *

Student First and Last Name *

Student's Classroom *

Check your child for these symptoms before they come to school

Temperature of 100.4 or above
Sore throat
Cough
Shortness of breath or difficulty breathing
Diarrhea
Vomiting
Upset stomach
Loss of taste/smell
New onset of severe headache
Runny nose and congestion
Muscle or body aches

Does your student have any of the above symptoms *

Yes

Does your child have any of these exclusionary symptoms: Check all that apply

Fever of 100.5 for 24 hours WITHOUT fever reducing drugs

If rash, sores or wounds are draining and cannot be covered or increasing in size

For Diarrhea or Vomiting until sympoms are gone for 24 hours

None

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