Underlying Conditions
This form is to determine which symptoms of a students pre-existing condition mimics COVID -19 symptoms.
* Required
Parent Name
*
Your answer
Student Name
*
Your answer
Underlying Condition
*
Please provide a description of what they underlying condition is. Example: Allergies, Migraines, Asthma, etc.
Your answer
Click which of the symptoms below are shown with your student's underlying condition.
*
Click all that apply.
Fever
Cough
Sore Throat
Runny Nose
Shortness of Breath
Required
Further Information.
If you with to provide more information about your student's underlying condition please add that information below.
Your answer
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This form was created inside of Peace Wapiti Public School Division.
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