Lenawee Intermediate School District COVID-19 Screening Questionnaire
The health and safety of our employees, students, contractors, volunteers, parents/guardians, and visitors remain the priority of the Lenawee Intermediate School District (LISD). As the Coronavirus disease 2019 (COVID-19) outbreak continues to evolve and spreads, the LISD is closely monitoring the situation and will periodically update District guidance, including campus and building access requirements, based on current recommendations from the Lenawee County Health Department, the State of Michigan, and the United States Centers for Disease Control and Prevention.

To prevent the spread of COVID-19 and reduce the potential risk of exposure to our students, workforce and visitors, we are conducting a simple screening questionnaire. Your participation is important to help us take precautionary measures to protect you and everyone in this building.

If your response to either question is yes, you are prohibited from entering a LISD school/building and/or being present on a LISD campus. If you are an employee, please contact your supervisor as soon as possible. If you are a visitor, please contact the LISD employee who arranged for your visit or for whom you were visiting.
Name *
Cell Phone Number *
Staff or Visitor? *
Supervisor or Staff Coordinating Access
LISD Campus/School(s) to be Worked In/Visited (select all that apply) *
Required
Have you been in close contact (within six feet) of another person who has tested positive for COVID-19 within the past 14 days? *
2. Do you currently have any symptoms of COVID-19, such as fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and/or diarrhea? *
3. Have you engaged in recent international travel? *
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