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OLSOS Health Survey
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Student Full Name and Grade *
Review the following questions daily and STAY HOME if the answer is "YES".
Does your child have any of the following symptoms not caused by another condition?
Check if YES *
Have you been in close contact with anyone with confirmed COVID-19? Close contact means being within 6ft (2 m) of an infected person for 15 minutes or more. *
Have you had a positive COVID-19 test for active virus in the past 10 days? *
Within the past 14 days, has a public health or medical professional told you to self-monitor, self-isolate, or self-quarantine because of concerns about COVID-19? *
If you answered YES to any of these questions, stay home and contact the school.
Phone: (360) 373-5162 Email:
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