St. Aloysius Academy Daily Check 21-22
Please complete the following form between 6:00 am and 7:30 am each day.  Please complete one form per student.  Please note that if you answer "Yes" to either of the last two questions, you must keep your child at home and contact the school office.

Thank you for your understanding and your commitment to keeping our school community safe.
Sign in to Google to save your progress. Learn more
Email *
Student's Full Name (First and Last) *
Grade *
Required
In the last 24 hours, did the student have close contact with someone diagnosed with COVID-19? *
In the last 24 hours, did the student return to the country from traveling internationally? *
In the last 24 hours, has the student experienced any of the following new symptoms: cough, shortness of breath, difficulty breathing, or lack of smell or taste (without congestion)? *
In the last 24 hours, has the student experienced any TWO of the following new symptoms: fever/elevated temperature, sore throat, chills, muscle pain, fatigue, headache, congestion/runny nose, nausea, vomiting, diarrhea? *
If you answered YES to either of the last two questions, the student may NOT enter school.  By accepting, you agree that your answers are truthful to the best of your knowledge. *
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ST.ALOYSIUS ACADEMY. Report Abuse