ECA/CEC Daily COVID-19 Questionnaire
Please fill out BEFORE you report to school. You only need to do it if you are physically in the building that day.
Email address *
Name *
Today's Date *
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Time *
Time
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Please take your temperature and record the number below. *
In the past 24 hours, have you experienced any NEW or UNEXPECTED symptoms such as: fever, chills, sweating; frequent dry cough; shortness of breath, difficulty breathing; fatigue; muscle or body aches and pains; sore throat, runny nose, congestion; diarrhea, vomiting; headaches; loss of taste or smell. *
Have you or anyone in your household recently been in close contact with anyone who has exhibited any symptoms? *
Have you or anyone in your household recently been in contact with anyone who has tested positive for COVID-19? *
If your answer to any of the above questions is "YES", DO NOT report to school. Contact Pat or Rebekah immediately. It is highly recommended that you consult with a medical professional or call the COVID Hotline @ 1-855-600-3453.
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