Lincoln Ave School COVID-19 Daily Screening

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Email *

First Name *

Last Name *

Any of the symptoms below could indicate a COVID-19 infection and a risk for spreading illness to others. Please note that this list does not include all possible symptoms and you may experience any, all, or none of these symptoms. Please check yourself daily for these symptoms: Column A: *

Fever (Measured or subjective)

Chills

Rigors (shivers)

Myalgia (muscle aches)

Headache

Sore Throat

Nausea or Vomiting

Diarrhea

Fatigue

Congestion or runny nose

None

Required

Column B: *

Cough

Shortness of Breath

Difficulty Breathing

New loss of smell

New loss of taste

None

Required

If TWO OR MORE of the fields in Column A are checked off or AT LEAST ONE field in column B is checked off, please stay home home and notify the school for further instructions

Section 2 Close Contact/Potential exposure *

You have had close contact (within 6 feet an infected person for at least 10 minutes) with a person confirmed positive for COVID-19

Someone in your household is diagnosed with COVID-19

You have traveled to an area of high community transmission.

None

Required

If ANY of the fields in Section 2 are checked off, you should remain home for 14 days from the last date of exposure or date of return to New Jersey. Contact your provider or your local health department for further guidance.

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