COVID-19|Daily Questions
Please fill this out for each child
Email address *
CHILD|Last Name *
CHILD|First Name *
Have your child or anyone in your home had fever of 100 or more, dry cough, chills, vomiting, diarrhea, or rash in the last 24 hours?
25 points
Clear selection
Have you or anyone with whom you have had direct and regular contact been confirmed or presumed to be positive for COVID-19?
25 points
Clear selection
Have you or anyone with whom you have had direct and regular contact traveled outside of the United States in the past 2 weeks?
25 points
Clear selection
Has anyone in your house hold been asked to self isolate or quarantine by a medical professional or local health official?
25 points
Clear selection
A copy of your responses will be emailed to the address you provided.
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