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DAILY SYMPTOM QUESTIONNAIRE
All students, staff as well as any visitors coming on campus are required to complete the Student Daily Symptom Questionnaire in order to ensure that we are limiting exposure to any COVID like symptoms.
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First Name
*
Your answer
Last Name
*
Your answer
Choose 1
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Student
Staff
Other:
In the past 24 hours have you experiences any of the following COVID-19 symptoms?
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new onset Cough
Shortness of breath or difficulty breathing
Chills
Fatigue
Muscle or Body aches
Sore throat
New loss of taste or smell
Congestion or runny nose
Nausea or vomiting
Diarrhea
NONE OF THE ABOVE
Required
Have you had a close contact with someone that tested positive for COVID-19 within the last 24 hours? Close contact meaning within 6 ft or less for 15 minutes or more.
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Yes
No
In the past 3 days have you had a fever of 100 Degrees or higher?
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Yes
No
If yes to any of the above symptoms - Students please contact Nurse Jessica and Staff please contact your director to discuss quarantine guidelines.
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