Cardinal O'Hara Student Wellness Check
This form needs to be completed each day you are in school for all students at Cardinal O'Hara.
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Email *
First Name *
Last Name *
Student Number
Date you are coming to school (NOT your birthday) *
MM
/
DD
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YYYY
Time *
Time
:
In the last week, have you been in contact with someone who has a fever, new cough, shortness of breath, or been newly diagnosed with COVID-19? *
People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. Symptoms may appear 2-14 days after exposure to the virus. Per CDC guidelines, people with these symptoms may have COVID-19: *
No
Yes
Fever 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
Have you traveled outside of Pennsylvania in the last 14 days? If yes, please check the PA TRAVEL ADVISORIES site.  https://rb.gy/kax6ku    If you visited any of those areas, please check Yes *
A copy of your responses will be emailed to the address you provided.
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