Student Travel Screening
Please complete the following form.  This information will help us protect all staff, students, and community.
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Name *
Grade *
Have you traveled to any of the CDC identified Level 3 countries in the last month? LEVEL 3 COUNTRIES: China, Iran, South Korea, Austria, Belgium, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, Netherlands, Norway, Poland, Portugal, Slovakia, *
Have you traveled to any of the following states in the last 2 weeks: California, Colorado, Georgia, Illinois, Massachusetts, or New York? *
Have you traveled to any of the following Texas locations in the last 2 weeks: Dallas, Houston, Ft. Worth, Austin, San Antonio, or El Paso? *
Have you been in contact with anyone known to have tested positive for COVID 19? *
Are you currently, or have you exhibited in the last 14 days, the following symptoms. *
Required
Please list any additional places you have traveled in the last two weeks. *
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