Screen + Stay Symptom Checker
By electronically signing this form below and submitting it, you are indicating that you wish to have your student continue participating with in-person learning despite being identified as a close contact of a Covid-19 case and that you agree with the following statements:
1) I have read the Screen and Stay guidance document and I understand the requirements for my student to continue with in-person learning instead of quarantining at home.
2) I understand that Screen and Stay applies only to in-person learning and that my student must continue to quarantine away from public/team athletic/social activities and follow normal quarantine procedures for other activities (e.g., team sports, extracurricular activities, gatherings with individuals outside of their household, etc.)
3) I (or another adult) will perform a daily symptom assessment of my student each morning at home prior to the student boarding a school bus or otherwise reporting to school for a full 14 calendar days.
4) The student will quarantine at home and not report to school, and I will contact the school IF they experience any of the Covid-19 symptoms listed in the next section at any time during the 14-day monitoring period.
Sign in to Google to save your progress. Learn more
Next
Clear form
Never submit passwords through Google Forms.
This form was created inside of Sterling Community School. Report Abuse