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Maine South Fine Arts COVID-19 Screening
This screening is to be filled out daily. After screening is filled out a temperature must be obtained before being allowed to participate.
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* Indicates required question
Email
*
Your email
Email address
*
Your answer
Last Name
*
Your answer
First Name
*
Your answer
Activity
*
Music
Drama
Dance
Visual Arts
Broadcasting
Required
Date
*
MM
/
DD
/
YYYY
In the last 24 hours have you experienced fever, cough, chills, and or muscle aches? (And these symptoms cannot be explained by other conditions...)
*
Yes
No
In the last 24 hours have you experienced a sore throat, runny nose, and/or loss of taste or smell? (And these symptoms cannot be explained by other conditions..
*
Yes
No
In the last 24 hours have you experienced nausea or vomiting? (And these symptoms cannot be explained by other conditions...)
*
Yes
No
In the last 24 hours have you experienced shortness of breath and or headache? (And these symptoms cannot be explained by other conditions...)
*
Yes
No
Have you come in close contact or cared for someone with COVID-19 in the last 14 days?
*
Yes
No
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