THS Staff Daily Temperature/ Health Confirmation

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Thornton Staff, complete this form by 8:30 a.m. ONLY if you plan to be on campus for any given workday. If you answer "YES" to any of our questions, you are directed to stay home and please follow the district's employee absence guidelines. You do not need to complete this form if you will not be on campus. Thank you.
PLEASE NOTE: If you have been in close contact* with someone who has tested positive for COVID-19 you will need to quarantine for 14 days from date of last exposure. If you are scheduled to work on campus, please contact your site supervisor/administrator for guidance.

*A close contact is someone who was in direct and close contact (less than 6 feet for more than 15 minutes) to someone who is a confirmed COVID-19 case.

Email *

Today's Date *

YYYY

First Name *

Last Name *

Within the past 48 hours *

Yes

My temperature had been above 100.4 degrees

I have taken medication for the purpose of reducing a fever

I have been coughing

I have had shortness of breath

I have had difficulty breathing

I have had a chills

I have had repeated shaking with chills

I have had muscle pain

I have had a headache

I have had a sore throat

If working on campus, please indicate the room/office that you will be working in.

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