KPDSB Student Risk Assessment

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

This risk assessment should be used by families who's children have had to travel outside of the Northwestern Health Unit region (English River to the Manitoba Border) for essential reasons and should be completed once you have returned home. Please note, as per the Northwestern Health Unit, essential reasons for travelling may include: accessing medical services, shared parenting arrangements, palliative visits, etc.

To successfully complete this risk assessment so your child can return to school following essential travel, you must be able to check off all of the boxes in Question 5. If you cannot check off every box, your child is required to stay home from school for 14 days. Academic support will be provided for any students who cannot return to class following travel.

If you travelled in the Northwestern Health Unit region only (English River to the Manitoba Border), you do not need to complete this risk assessment and your child can return to school as long as they can pass the Ontario School Screening - https://covid-19.ontario.ca/school-screening/

If your child travelled outside of the Northwestern Health Unit region for non-essential reasons, you do not need to complete this risk assessment and your child is required to stay home for 14 days from the date you returned to the area. Academic support will be provided for these students.

Please complete one form per student. Please note, students 18 years of age or older can complete this form themselves and do not require a parent/guardian to complete it for them.

Email *

1. Parent/Guardian Name (if completing as a student 18 years of age or older, please enter your name below) *

2. Name of Student *

3. Student's School *

4. Student's Grade *

5. In order to successfully complete this risk assessment for your child to return to school after essential travel outside of the Northwestern Health Unit region, you must be able to check all of the boxes below and your child must be pass the Ontario School Screening Tool each day. If you are unable to check every box, you should contact your child's school. *

My child did not use public transportation

My child maintained physical distancing or used a mask when physical distancing could not be avoided

My child avoided crowded areas

My child did not attend noisy events or places where people are speaking loudly, as this causes people to spit when talking

My child limited their interactions with others

My child did not spend time in a setting that has since been declared as an outbreak or possible exposure.

My child/family did not receive a notification of possible exposure on the COVID Alert App

My child practiced hand hygiene

Required

6. What date did your child return from their essential travel? *

YYYY

7. By checking the box below, you are indicating that the information provided above is accurate. *

I certify that the information provided in this form is accurate, that my child travelled for essential reasons, and that my child took all necessary precautions during their travel

Required

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of Keewatin-Patricia District School Board. Report Abuse

Forms