JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
2020 Girls Strength and Skills Health Screening
Health Screening
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Last name
*
Your answer
First Name
*
Your answer
Incoming Grade Level
*
Choose
9th
10th
11th
12th
Please check the appropriate box below if you have experienced any of these Covid-19 related symptoms in the last 14 days:
*
Cough
Shortness of breath or difficulty breathing
Chills
Repeated shaking with chills
Headache
Sore throat
Loss of taste or smell
Diarrhea
Feeling feverish or a measured temperature greater than or equal to 100.0 degrees Fahrenheit
Known close contact with a person who is lab confirmed to have Covid-19 if exposure to the active confirmed person
None of the above
Required
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lorena ISD.
Report Abuse
Forms
