STUDENT Daily Screener - Coit
School Name: COIT CREATIVE ARTS ACADEMY

Complete the screener below.

Haga clic aquí para leer en español: https://www.grps.org/images/Student_Health_Screener_SP.pdf
Kanda hano usome ibi muri Ikinyarwanda: https://www.grps.org/images/Student_Health_Screener_KY.pdf
Bonyeza hapa kusoma kwa Kiswahili: https://www.grps.org/images/Student_Health_Screener_SW.pdf
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Student Grade *
1. Student's First Name *
2. Student's Last Name *
3. Has your child had close contact (within 6 feet for 15 minutes or more) with a person who has been confirmed to have COVID-19 in the last 14 days? *
4. Is anyone in your household awaiting a pending COVID-19 test result? *
5. Does your child have any of the following symptoms? *
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IMPORTANT NOTIFICATION: If you answered "YES" to any of the above questions, your child may not attend school or athletics/other activities today. Please contact your school for more information. *
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