Senior High - Daily Health Check (STUDENTS)

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Students should stay at home when new symptoms of illness develop. For mild symptoms without fever, such as sore throat, headache, runny nose, fatigue, loss of appetite or muscle aches, students should monitor at home for 24 hours. If symptoms improve, they can return to school without further assessment. A full list of COVID-19 symptoms is available from BCCDC.

Please complete this form daily for each child attending school at KGMS/MAHS prior to your child coming to school. The list of symptoms is reviewed regularly based on the BC Centre for Disease Control's list of symptoms of COVID-19. This form has been updated to reflect the BC Centre for Disease Control's new key symptoms of illness. September 20, 2020.

If you answered “YES” to any of the questions, your child should NOT come to school.

If they are experiencing any symptoms of illness, contact a health care provider for further assessment. This includes 8-1-1, or a primary care provider like a physician or nurse practitioner.

If you answered “YES” to questions 2 or 3, use the COVID-19 Self-Assessment Tool (via google) to determine if you should be tested for COVID-19.

Child's name *

1. Symptoms of Illness - Does your child have any of the following symptoms? *

None

Fever (38c or higher)

Chills

Cough or worsening of chronic cough

Shortness of Breath

Loss of sense of smell or taste

Diarrhea

Nausea or vomiting

Required

2. International Travel - Have you or anyone in your household returned from travel outside of Canada in the last 14 days? *

Yes

3. Confirmed Contact - Are you a confirmed contact of a person confirmed to have COVID-19? *

Yes

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of Kenneth Gordon Maplewood School. Report Abuse

Forms