6B - Daily Health Check

Не удалось открыть файл, поскольку в вашем браузере отключено использование JavaScript. Включите его и перезагрузите страницу.

For the health and safety of the entire school community, please fill out this form every morning before taking your child to school. If it is incomplete, you will have to complete a survey before dropping off your child at school.

Чтобы сохранить изменения, войдите в аккаунт Google. Подробнее…

Электронная почта *

Please enter your Child's Name. *

Please enter your child's temperature. If it is above 100 degrees Fahrenheit, please keep your child home. *

Is your child experiencing any symptoms associated with Covid-19? Please select all that apply: *

Chills

Cough

Shortness of Breath or Difficulty Breathing

Fatigue

Muscle or Body Aches

Headache

Loss of Taste or Smell

Sore Throat

Congestion or Runny Nose

Nausea or Vomiting

Diarrhea

No Symptoms

Другое:

Обязательный вопрос

If you selected "Other" in the question above, please list the symptom below:

Have you or your child been in close contact with a person who is under investigation or confirmed to have COVID-19? *

Yes

If you selected "Yes" to the question above, is that person in isolation away from you and your child?

Yes

Отменить выбор

Has your child traveled in the last 10 days? *

Yes

Please list your initials to confirm that the responses above are accurate. *

To return to Student Daily Health Check-In Website, click the link below:

https://saskailua.org/student-daily-health-check-in/

Отменить выбор

Отправить мне копию ответов

Отправить

Очистить форму

Никогда не используйте формы Google для передачи паролей.

reCAPTCHA

Конфиденциальность Условия

Форма создана в домене St. Anthony School. Сообщение о нарушении

Формы