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Student Daily Screener
Before leaving for school, please make sure to complete the following screener. If your child has any of these symptoms, that indicates a possible illness that may decrease the student's ability to learn and put them at risk for spreading illness to others, please follow the guidance at the bottom of the screener for next steps.
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Student's First Name
Student's Last Name
Section One: Symptoms (Check all that apply)
NONE OF THE BELOW
Temperature 100.4 degrees fahrenheit or higher when taken by mouth.
New uncontrolled cough that causes difficulty breathing (for students with chronic allergic/asthmatic cough, a change in their cough from baseline)
Diarrhea, vomiting, or abdominal pain
New onset of severe headache, especially with a fever
Section Two: Close Contact/Potential Exposure (Check all that apply)
NONE OF THE BELOW
Had close contact (within 6 feet of an infected person for at least 15 minutes) with a person with confirmed COVID-19: OR
Had close contact (within 6 feet of an infected person for at least 15 minutes) with person under quarantine for possible exposure to COVID-19: OR
Traveled to or lived in an area where the local, Tribal, territorial, or state health department is reporting large numbers of COVID-19 cases as described in the
(Community Mitigation Framework)
Lived in an area of high community transmission (as described in the Community Mitigation Framework
) while school remains open.
Please follow these guidelines for if you answered YES to any of these questions:
If the answer is YES to any of the questions in Section One AND YES to any of the questions in Section Two Call your healthcare provider right away to get evaluated and tested for COVID-19. If you don’t have one or cannot be seen, go to
or call 2-1-1 to find a location to have your child(ren) tested for COVID-19.
If the answer is YES to any of the symptom questions, but NO to any close contact/potential exposure questions, your student may return based on the guidance for their symptoms:
• Fever: at least 24 hours have passed with no fever, without the use of fever-reducing medications
• Sore throat: improvement (if strep throat: do not return until at least 2 doses of antibiotic have been taken);
• Cough/Shortness of breath: improvement
• Diarrhea, vomiting, abdominal pain: no diarrhea or vomiting for 24 hours
• Severe headache: improvement
If the answer is NO in Section 1, but YES in Section Two for being in close contact with someon with a confirmed case of COVID-19, your student should be tested. However, if they answer YES to having close contact with a person under quarantine and they have not tested positive for COVID-19, they may return to school if quarantined person and student do not have symptoms. If there is any question of whether your student should come to school, please contact the school building office or your healthcare provider for clarification.
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This form was created inside of Delton Kellogg Schools.