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TCCS Pre-screening Daily Health Check Form
Please record daily temperature checks and symptoms/contact tracking using this form.
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* Indicates required question
Student's Last Name
*
Your answer
Student's First Name
*
Your answer
Date
*
Choose
08/04
08/05
08/06
08/07
08/08
08/09
08/10
08/11
08/12
08/13
08/14
08/15
08/16
08/17
What was your Child's Temperature
*
Your answer
Has your child had any covid-19 symptoms?
*
Yes
No
To your knowledge, has your child or a family member been in close contact with anyway having covid-19 symptoms?
*
Yes
No
Student's Grade
*
Choose
K
1
2
3
4
5
6
7
8
9
10
11
12
Staff
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