Student Symptom Certification
To be completed by parent each morning prior to your student's arrival to school.
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Email *
IDPH requires that schools conduct symptom screenings and temperature checks or require that individuals self-certify that they are free of symptoms before entering school buildings.
Full name of student wishing to enter the building: *
Full name of individual completing Student Symptom Certification: *
Has your student received a confirmed diagnosis for coronavirus (COVID-19) by a coronavirus (COVID-19) test or from a diagnosis by a health care professional in the past 14 days? *
Has your student had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days? *
Has your student experienced any cold or flu-like symptoms in the last 14 days (to include: fever or temperature of greater than 100.4 degrees Fahrenheit/38 degrees Celsius), new onset of moderate to severe headache, shortness of breath, new cough, sore throat, vomiting, diarrhea, abdominal pain from unknown cause, new congestion or runny nose, new loss of sense of taste or smell, nausea, fatigue from unknown cause, muscle or body aches? *
What is your student's current temperature? *
If you have answered yes to any question, please do not send your student to PRLC today.  Please contact Teresa VonRohr at (309) 495-6800 to discuss when your student will return.
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