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Discovery Preschool Daily Covid-19 Screening
This form is to be completed daily by the parent/guardian by 8:30 am daily. Only children with "no" answering will be allowed to attend school that day.
***NOTE THAT THE FORM HAS BEEN UPDATED, PLEASE READ CAREFULLY***
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* Indicates required question
Email
*
Your email
Date:
*
MM
/
DD
/
YYYY
Child's first and last name:
*
Your answer
Parent's first and last name
*
Your answer
Does your child have a fever?
*
Yes
No
Does your child have a cough?
*
Yes
No
Does the child have Shortness of Breath/Difficulty Breathing?
*
Yes
No
Has the child recently experienced a loss of sense of taste or smell?
*
Yes
No
Is the child Feeling unwell/Fatigued?
*
Yes
No
Does the child have Nausea/Vomiting/Diarrhea?
*
Yes
No
Has the child, or anyone in your household, travelled outside of Canada in the last 14 days?
*
Yes
No
Has the child had close *unprotected contact (face-to-face contact within 2 meters/6feet) with someone who is ill with cough and/or fever?
*
Yes
No
Has your child been identified as a Close Contact (as defined by AHS) of a confirmed COVID-19 case? (
https://www.albertahealthservices.ca/topics/Page17221.aspx
)
*
Yes
No
Disclaimer
If you have answered “Yes” to any of the above questions, your child MAY NOT enter at this time.
Our goal is to minimize the risk of infection to our staff, children, and their families thank you for your understanding and cooperation.
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