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Revised Daily Health Screening Questions -October SACA
**Note some of the questions and the wording has changed ...
Please complete this screening form each day before arriving to school.
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1.
In the past 10 days, Has your child experienced any symptoms of COVID-19, including a fever of 100.0 degrees F or greater, a cough, loss of taste or smell or shortness of breath that started in the past 10 days?
*
No. You may go to school.
Yes. You may NOT go to school.
2.
To the best of your knowledge , in the past 10 days has your child been in close contact (within 6 feet for at least 10 minutes over 24 hour period) with anyone who has tested positive for COVID -19?
*
No. You may go to school.
Yes. You may NOT go to school.
Student Name
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Your answer
Student Class
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Your answer
Parent Name
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Your answer
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