Monroe High School Daily Covid-19 Screening Form
Coaches and players need to sign in daily to complete the required Covid-19 Screening.
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Student's First Name
Student's Last Name
Name of person completing this form.
Parent/Guardian Phone Number
Student's Daily Temperature
Does your student have a fever greater than or equal to 100 degrees or fever symptoms of chills alternating with sweating?
Yes (must stay at home until fever free without fever reducing medication for 3 days)
No (continue to the next question)
Has your student traveled outside Alaska within the past 14 days?
Yes (be sure to follow state mandates regarding travel
Have you or someone in your household, had close unprotected contact with a known COVID-19 patient (spent more than 10 minutes within 6 feet of someone who was sick with a fever and cough)?
Yes (must quarantine for 14 days without symptoms before returning)
No (continue to next question)
Does your student have any of the following symptoms?
Trouble breathing, shortness of breath, wheezing
Loss of Smell and/or Taste
None (you may participate if no symptoms)
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