ES COVID-19 Google Forms Survey Questions for Legal Guardians

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ES COVID-19 Google Forms Survey Questions for Legal Guardians

NOTE: IF YOU HAVE MULTIPLE STUDENTS IN YOUR FAMILY, YOU MUST FILL THIS FORM OUT FOR EACH STUDENT.

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* Indicates required question

Email *

Your email

First Name of Student *

Your answer

Last Name of Student *

Your answer

Grade *

Pre-K 3

Pre-K 4

Kindergarten

1

2

3

4

5

6

7

8

Parent Cell Phone Number *

Your answer

Please choose one of the two options regarding the COVID-19 Screening Questionnaire. *

Cleared (I answered No to all of the questions).

Not Cleared (I answered Yes to one or more of the questions in any of the four sections).

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