COVID-19 Daily Questionnaire
Please complete this COVID-19 questionnaire before arriving to school each day. If yes is answered to any of the following questions, you will need to be cleared by a physician to return.
Student Last Name
Select your Grade Level
Have you been exposed to an individual that has tested positive with COVID? If yes, you must be cleared by a physician to return.
Have you traveled internationally or to a heavily impacted zone within the US in the last 14 days?
If yes, where:
Have you experienced a fever, chills, breathing difficulty, loss of taste or smell, fatigue, nausea, vomiting, headache, or diarrhea?
If yes, explain:
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This form was created inside of Bishop T.K. Gorman Catholic School.