Student Daily Health Screening
Parent: please complete this form daily before 7:45 AM.  *THIS FORM MUST BE SUBMITTED IN THE MORNING!
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Email *
Child's Name *
1. Does your child have any of the following symptoms, that indicates a possible illness that may decrease the student’s ability to learn and also put them at risk for spreading illness to others? · Temperature 100.4 degrees Fahrenheit · Sore Throat *New uncontrolled cough that causes difficulty breathing (for students with chronic allergic/asthmatic cough, a change in their cough from baseline) · Diarrhea, vomiting, or abdominal pain · New onset of severe headache, especially with a fever · Shortness of breath · Fatigue · Muscle or body aches · New loss of taste or smell · Congestion or runny nose · Nausea or vomiting · Diarrhea * * *
2. To the best of your knowledge, in the past 14 days, has your child been in close contact (within 6 feet for at least 10 minutes) with anyone who has tested positive through a diagnostic test for COVID-19 or who has or had symptoms of COVID-19? * * *
3. Has your child  OR a MEMBER OF YOUR HOUSEHOLD traveled internationally or from a state with widespread community transmission of COVID-19 per the New York State Travel Advisory in the past 14 days. * * *
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