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Lindop Student Daily COVID Screening Form (PreK-8th)
Note: This information is private and will only be viewed by screener, administration and/or nurse.

This screening form must be completed for EACH student daily by 7:45 a.m.

No fever-reducing medication has been taken prior to arrival to the building.

I understand that if my child becomes symptomatic during the school day, I will make arrangements to have my child picked up as soon as possible (if necessary) at DOOR H (2nd/3rd grade door).
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Email *
Student's Name *
Today's date *
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DD
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Grade Level *
Homeroom Teacher *
RECENT EXPOSURE: My child has had recent contact (within the last 14 days) with someone who is diagnosed/known COVID-19 positive. *
SYMPTOMS: My child is experiencing ONE OR MORE OF THE FOLLOWING: cough, shortness of breath, sore throat, nausea, vomiting, diarrhea, abdominal pain, new loss of taste or smell, chills, headache, muscle pain, fatigue, nasal congestion, runny nose *
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