Self-Evaluation COVID-19 Screening Test

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Parents,

Please carefully fill out the Self-Evaluation COVID-19 Screening Test to ensure student safety prior to entering the school campus.

Thank you!

SUBMIT ONE PER STUDENT

Email *

Have you or anyone in your household been tested for COVID-19? *

Yes

Have you experienced any of the following sympotms? *

Fever or chills

Cough

Shortness of breath or difficulty breathing

Fatigue

Muscle or body aches

Headache

New loss of taste or smell

Sore throat

Congestion or runny nose

Nausea or vomiting

Diarrhea

None

Required

Have you or anyone in your household traveled within or outside the U.S. in the past 21 days? *

Yes

Do you have any reason to believe you or anyone in your household has been exposed to or acquired COVID-19? *

Yes

Select your child's grade. *

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