St. Thomas' Preschool Health Check-In
Student Daily Heath Check. No judgement zone-- Be Honest & We are in this together! There is a space at the end of the form to explain any answers. Thank you.
Name of Family *
In the past 24 hours has your child(ren) experienced any of the following symptoms: dry cough, fever, nausea, vomiting, diarrhea, red toes, loss of taste or smell, rash, fatigue, shortness of breath? *
Required
In the past 24 hours, has your child received any fever reducing medication? *
Required
In the past 24 hours, has anyone in your household experienced any of the following symptoms: dry cough, fever, nausea, vomiting, diarrhea, red toes, loss of taste or smell, rash, fatigue, shortness of breath? *
Required
In the last 2 weeks, has anyone in your household knowingly come in contact with anyone who has tested positive for COVID-19? *
Required
In the last 2 weeks, has anyone in your household traveled outside of the U.S. or to a state in the "Red Phase"? *
Required
Anything else you would like to share today, and any explanations to questions above. Thank you!
Signature *
Submit
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