VBPS Covid-19 Daily Questionnaire
This form must be filled out and submitted daily prior to your child entering the building.
This form must be complete prior to your child riding a VBPS bus and no later than 8AM.
VBPS Staff will be viewing the forms every morning.
If your child's form is not submitted daily you will be asked to pick them up from school.
For confirmation of your submission, please choose "Send me a copy of my responses." when you submit this form.
Please double check your child's student number for accuracy. If the student number is wrong, the form will not show up as submitted for your child.
Student Last Name
Student First Name
What grade level is your child in?
What school does your child attend?
Will your child be using VBPS transportation to get to school today?
This information is used in the event that we need to contact trace.
Has your child experienced either of the two situations in the image above in the last 24 hours?
Student has ONE of these symptoms: New or worsening cough? Shortness of breath? Difficulty breathing? New loss of taste or smell? OR Student has any TWO of these symptoms: Fever 100.4 or greater? Vomiting or diarrhea? New headache? Sore throat? Runny nose and/or congestion? Body aches and/or tiredness?
Send me a copy of my responses.
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This form was created inside of Van Buren Public Schools.