COVID-19 Before-School Parental Screening of Students

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The more people a student or staff member interacts with, and the longer that interaction, the higher the risk of COVID-19 spread. As such, please complete the survey below on a daily basis prior to your child's arrival on school premises.

Email *

Student Name: *

Does your child have a new onset of any of the following symptoms? *

Cough and/or respiratory symptoms

Fever: 100.4 or higher

Abdominal pain

Chills

Diarrhea

Difficulty breathing/shortness of breath

Headache

Loss of appetite

Loss of smell and/or taste

Muscle aches/pains

Sore Throat

Vomiting

NONE

Required

Did your child receive any fever-reducing medication (Tylenol, Advil, etc.) this morning? *

Yes

If the answer is "yes," what was the indication?

Within the past 14 days, has your child or any member of your household had direct contact with anyone with confirmed COVID-19? *

Yes

Within the past 14 days, has your child or any member of your household travelled outside of the state or the country? *

Yes

Send me a copy of my responses.

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