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Moving Everest COVID-19 Student Symptom Screener
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Email
*
Your email
Email Address
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Your answer
Student Name
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Your answer
Grade
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Choose
Kinder
1st
2nd
3rd
4th
5th
6th
Parent's Name
*
Your answer
Phone #
*
Your answer
In the last 24 hours, has your scholar experienced any of the following symptoms that you can not attribute to another health condition? Please check all that apply.
*
Fever (≥100.4*F ) or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
No symptoms
Required
Has your child or anyone in your household been in contact with a confirmed case of COVID-19 within the past 14 days?
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Yes
No
Has anyone in your household traveled within the last 14 days to any country or urban center considered high-risk by the CDC?
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Yes
No
Has anyone in your household tested positive in the last 14days?
*
Yes
No
Are you waiting on the results of a COVID-19 test?
*
Yes
No
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