Harrisburg Elementary Student Health Screen

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Please complete this form before you leave your home to bring your child to HES. If possible, check your child's temperature just before you leave your house for the bus stop or to come to school. If the form is not completed, your child may not be allowed to stay at school.

Email *

Student Last Name *

Student First Name *

Please take your child's temperature and record it here *

Does your child have any of these symptoms this morning? *

Yes

Difficulty Breathing

Unexplained Cough

Sore Throat

New Loss of Taste or Smell

Within the past 14 days, has your child been in direct contact with anyone who tested positive for COVID-19? *

Yes

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