COVID-19 School Health Screening Agreement

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For the health and safety of our students, Oakland County Health Division (OCHD) requires students to be screened for symptoms of COVID-19 before getting on a bus or entering school. The Centers for Disease Control and Prevention (CDC) do not recommend screenings be done by the schools in consideration of time and interruption to education.

As part of the required protocols for In-Person learning, parents/guardians, must complete this form to indicate your understanding and agreement to perform daily symptom screenings on your child.

COMPLETE A SEPARATE FORM FOR EACH CHILD ATTENDING HOLLY AREA SCHOOLS.
Thank you

Email *

By completing this form, I am committing to screening my child daily for the 2020-2021 school year, unless otherwise directed. I also understand that it is my responsibility to call the school immediately if my child is not going to school for potential COVID-19 symptoms. *

Check here to acknowledge the above statement.

Required

List your child's first and last name *

Choose your child's grade level *

Name of parent/guardian completing the form *

Best phone number to reach you: *

Choose the school your child attends. *

Send me a copy of my responses.

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