Plano ISD Fine Arts Daily Self-Screening Tool - Clark HS Band - Oct. 12

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Plano ISD Fine Arts Daily Self-Screening Tool - Clark HS Band - Oct. 12 - 16

Prior to arriving at a Plano ISD campus, please complete the following self-screening tool to ensure you are safe to be on campus. If you answer YES to any of the following questions, on-site attendance is RESTRICTED. Please stay at home and notify your director.

Email *

Student ID Number *

First Name *

Last Name * *

Grade for 2020-2021 school year * *

Marching Instrument *

In the past 14 days, have you had known contact with any person with lab confirmed case of COVID-19? * *

Yes

Do you feel feverish or have a measured temperature greater than or equal to 100? * *

Yes

Are you experiencing any of the following symptoms? Check ALL that apply. * *

Loss of Taste or Smell

Cough

Difficulty Breathing

Shortness of Breath

Headache

Chills

Sore Throat

Shaking or Exaggerated Shivering

Diarrhea

Significant Muscle Pain or Ache

I DO NOT HAVE ANY OF THE SYMPTOMS LISTED ABOVE

Required

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Plano ISD. Report Abuse

Forms