The Preschool at DUMC COVID Screening Form
Please fill out the information below before your child leaves for school each day.
Has your child had close contact with anyone with a confirmed case of COVID-19?
Has your child or anyone in your immediate family traveled out of state within the last 14 days?
If you answered yes to the question above, to which state did your child or immediate family travel? (type N/A if answer above was no)
Check any symptoms that your child has displayed that cannot be attributed to another health condition in the last 24 hours:
Persistent pain or pressure in chest
Difficulty breathing/shortness of breath
Muscle or body aches
New loss of taste or smell
Nausea or vomiting
None of the above
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