Symptoms Report

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Symptoms Report

Fill out this report to receive instructions for clearing your student to return to school after having symptoms of illness. We MUST rule out COVID-19 before your student may return to campus. Supervised testing is required.

If you are reporting symptoms for more than one student, fill out one form per student.

Email *

Student First Name *

Student Last Name *

Student ID Number *

Grade *

Teacher's Name (Elementary only)

School Site *

What date did your student's symptoms begin? *

YYYY

What date was your student last at school? *

YYYY

Select any symptoms that are present: *

Sore throat or scratchy throat

Fever or chills

Cough

Shortness of breath or difficulty breathing

Fatigue

Muscle or body aches

Headache

New loss of taste or smell

Congestion or runny nose

Nausea or vomiting

Diarrhea

Required

Send me a copy of my responses.

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