Covid-19 Questionnaire
Waltrip Ram Band

This form must be filled out each time you attend an "In Person" Event as part of our Check-In Procedures.

All students, employees, and visitors must wear a mask on HISD property.

If student, employee, or visitor is exhibiting any obvious signs of illness (pallor, redness of cheeks/face, continuous coughing, shortness of breath), has been exposed to COVID-19, has a temperature greater than or equal to 100.0 ° F (37.7° C), answers yes to any of the symptoms below, or refuses to wear a mask, they will be denied entry.
Type Your Last Name *
Type Your First Name *
Type Your ID# *
Have you traveled out of state within the past 14 days? *
If you selected yes on the previous question type where?
Do you have a fever over 100 degrees? *
Have you came in contact with someone who has a confirmed positive test for Covid-19 within the past 3 weeks? *
Have you had any of the following symptoms in the past 48 hours? *
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