AVETNS Student Pre-Return to School Covid-19 Questionnaire
This questionnaire is to be completed by parents at least 1 days in advance of their child returning to school after a closure.

If the answer is Yes to any of the below questions, you are advised to seek medical advice before returning to school.

Please note this data will be deleted at the end of the current school term.
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Student's Name *
1. As far as you are aware, does your child / a member of your child's household / a close contact of your child have: symptoms of cough, fever, high temperature, difficulty breathing, loss or change in your sense of smell or taste now or in the past 14 days?
清除選取的項目
2. As far as you are aware, has your child / a member of your child's household / a close contact of your child been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days? *
3. As far as you are aware, is your child / a member of your child's household / a close contact of your child awaiting the results of a Covid-19 test?
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4. In the past 14 days, has your child / a member of your child's household / a close contact of your child been in contact with a person who is a confirmed or suspected case of Covid-19?
清除選取的項目
5. As far as you are aware, has your child / a member of your child's household / a close contact of your child been advised by a doctor to self-isolate at this time?
清除選取的項目
6. As far as you are aware, has your child / a member of your child's household / a close contact of your child been advised by a doctor to restrict their movements at this time?
清除選取的項目
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請勿利用 Google 表單送出密碼。
這份表單是在 Aston Village Educate Together National School 中建立。 檢舉濫用情形
Google 表單