CBISD Student and Family Survey

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In an effort to help the district make informed decisions regarding the health and safety of our families and staff, please assist us with providing information. You only need to submit one survey per family. This will be kept strictly confidential and will be used to make informed decisions about the health and safety of our CBISD school community. Thank you for your participation and assistance.

Email *

Parent or Guardian Last name *

Parent or Guardian first name *

Best phone number *

Can this number be used to send text updates? *

Student last name *

Student first name *

School student attends *

Grade level *

Other children enrolled in CBISD. Please list first and last name, the grade level and school.

Will your family have limited access to meals during school closure? *

Yes

Is anyone in your household experiencing symptoms of COVID 19 ? Symptoms may occur 2-14 days after exposure and can include fever, cough and shortness of breath (for more information see the CDC website). *

Yes

Did any member of your household travel INTERNATIONALLY during Spring Break? *

Yes

If a member traveled INTERNATIONALLY, where did they go?

Did any member of your household travel to other states in the US during Spring Break? *

Yes

If a member traveled to another state in the US, where did they go?

Did any member of your household go on a cruise during Spring Break? *

Yes

If a member went on a cruise, where did they go?

Do any of the members of your family feel they may have been exposed to COVID 19? *

Yes

If any of the members of your family feel they may have been exposed to COVID 19, where did the exposure occur?

Send me a copy of my responses.

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