Student Health Questionnaire
Please complete and submit this form for your child every day before they arrive to school.
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Email *
1. What is your child's name? *
2. What is your name as the Parent/Guardian of the above-named child. *
3. What is your child's grade level? *
4. What is your child's current body temperature in degrees Celsius? *
5. My child will be attending In-person classes today. *
6. Is your child experiencing: *
Yes
No
Sore throat?
Body Pains?
Headache?
Fever for the past few days?
Cough
Cold
7. Please comment If you answered yes in any of the above (question #6).
8. Has your child been together with, or stayed in the same close environment as, a confirmed COVID-19 case within 5 days? *
Required
I am the parent/guardian of the above named child and I authorize Brent International School Baguio to collect and process the data indicated herein for the purpose of effecting control of the COVID-19 virus. I understand that my personal information is protected by RA 10173, the Data Privacy Act of 2012, and that I am required by RA 11469, the Bayanihan to Heal as One Act, to provide truthful information. *
Required
A copy of your responses will be emailed to the address you provided.
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