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STUDENT Daily Screener - Campus
School Name: CAMPUS
Complete the screener below.
Haga clic aquí para leer en español:
https://www.grps.org/images/Student_Health_Screener_SP.pdf
Kanda hano usome ibi muri Ikinyarwanda:
https://www.grps.org/images/Student_Health_Screener_KY.pdf
Bonyeza hapa kusoma kwa Kiswahili:
https://www.grps.org/images/Student_Health_Screener_SW.pdf
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* Indicates required question
Student Grade
*
Choose
PK
K
1
2
3
4
5
1. Student's First Name
*
Your answer
2. Student's Last Name
*
Your answer
3. Has your child had close contact (within 6 feet for 15 minutes or more) with a person who has been confirmed to have COVID-19 in the last 14 days?
*
Yes
No
4. Is anyone in your household awaiting a pending COVID-19 test result?
*
Yes
No
5. Does your child have any of the following symptoms?
*
Yes
No
IMPORTANT NOTIFICATION: If you answered "YES" to any of the above questions, your child may not attend school or athletics/other activities today. Please contact your school for more information.
*
I have answered this screening tool honestly to the best of my knowledge.
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