WORCESTER PUBLIC SCHOOL COVID-19 Student/ Staff Screening Tool

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Prior to sending your child to school, please answer the following questions with your child. If you answer yes to any of the questions, please do not send your child to school.

Name of the student you are checking in: *

What date are you filling this out for? *

What school does your child attend? *

What grade is this child in? *

Clear form

Never submit passwords through Google Forms.

This form was created inside of Worcester Public Schools. Report Abuse

Forms