BPCS COVID - 19 Student Daily Checklist

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If you reply YES to any of these symptoms please notify the school immediately.

Student's First and Last Name: *

Do your child have a fever? *

Yes

Is your child's temperature above 100.4? *

Yes

Has your child lost sense of taste or smell? *

Yes

Muscle Ache? *

Yes

Throat sore? *

Yes

Cough? *

Yes

Shortness of Breath? *

Yes

Chills? *

Yes

Headache? *

Yes

Nasal congestion? *

Yes

Fatigue? *

Yes

Has your child experienced any GI symptoms such as nausea/vomiting/diarrhea/loss of appetite? *

Yes

Has your child or anyone you have been in close contact with been diagnosed with COVID-19 or been placed in quarantine for possible contact with COVID-19? *

Yes

Has your child or someone that you have been in contact with traveled to a State that is on the travel advisory list for NJ? *

Yes

Statement *

I acknowledge that I have completed the student assessment and I have answered all the questions to the best of my ability.

Required

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