Children's Wellness Form

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Any child entering the classroom must have been free of the following symptoms for 24 hours or more: fever, cold/flu, green or yellow mucus, persistent cough, diarrhea, vomiting, discharge in or around the eyes, rashes and skin eruptions, and any contagious disease.

If your child has been exposed to any highly contagious illness (COVID, Chicken Pox, RSV, etc.) in the last 7 days they may not enter the Children's wing (so we can keep all of our friends healthy). Thank you for your understanding!

Email *

Child's Name: *

Classroom *

Any known exposure to any highly infectious disease (RSV, COVID, Chicken Pox, etc.) in the last 10 days? *

Yes

Required

Upon the recommendation of the Committee on Control of Infectious Diseases of the American Academy of Pediatrics, a child with any of the following symptoms should stay at home: *

A fever in the previous 24 hours (temperature 100° F or higher)

Stomachache, vomiting or diarrhea

Any symptom of a childhood disease such as chickenpox or whooping cough

A cold or nose with excessive or discolored drainage

Sore throat

Croup

Any unexplained rash

Any skin infection such as boils, ringworm, or impetigo

Any hair or skin infestation such as head lice

Pinkeye or other eye infection

None of the Above

Required

If you or your child has been EXPOSED to COVID

10 days since exposure

Symptom free

Negative COVID test

If you or your child has had COVID

10 days since symptoms first appeared

24 hours with no fever without the use of fever-reducing medications

Other symptoms improving

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