Sunday Meeting Health Screen

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Keeping Our Kids Safe at the Sunday Meeting

What is your child's name

What is today's date?

YYYY

In the past 20 days has your child been diagnosed with Covid 19?

Yes

Clear selection

Do you live with someone who is awaiting COVID test results because of COVID-type symptoms?

Please select ALL of the symptoms below that your child has experienced in the past 14 days that cannot be explained by a pre-existing condition.

Fever/Chills

Sore Throat

Shortness of Breath

Unexplained muscle aches

Cough

None of these

Please select ALL of the additional symptoms below that your child has experienced in the last 14 days that cannot be explained by a pre-existing condition.

Loss of smell or taste

Runny or congested nose

Diarrhea (3+ stools in 24 hrs)

Eye Redness +/- discharge

Unusuaally weak or fatigued

None of these

In the past 10 days has your child returned from travel outside the U.S.?

Yes

Clear selection

In the past 14 days has your child been in unprotected close contact with someone diagnosed with COVID? (close contact within 6 feet for 15 minutes or longer)

Yes

Clear selection

If you answered "none of these" and "no" to all of these symptom, travel and exposure questions, we are glad to include your child in today's Sunday meeting. Thank you for taking the time to ensure the safety of all of our kids. Do you have anything to add or questions to ask?

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