COVID-19 Performing Arts Daily Pre-Screening Question Form

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This forms needs to be completed daily, before each rehearsal, and must be completed prior to arriving on school grounds.

What activity are you participating in today? *

If "Other" was selected above, what Performing Arts Activity are you here for?

Email Address *

Last Name of Student, First Name *

School *

Grade *

Are you experiencing any of the following symptoms? *

Yes

Fever ( > 100.4 Degrees F)

Cough or shortness of breath

Sore Throat

Chills

Muscle aches or rigors

Headache

New loss of taste or smell

Abdominal pain, nausea, vomiting or diarrhea

Have you had close contact with someone who is currently sick? *

Yes

Have you been diagnosed with COVID-19 in the past three weeks or have reason to believe you have COVID-19? *

Yes

Have you been diagnosed with COVID-19 in the past three weeks or have reason to believe you have COVID-19? *

Yes

Have you traveled/visited any of the states that are on the NJ travel advisory list? *

Yes

If you answered yes to the question above, have you quarantined for 14 days upon your return to NJ? *

Yes

N/A

If you took your temperature this morning, what was the reading?

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