Family Time Screening COVID - 19
All parents and placement screening must be completed 4 hours prior to family time by all parties. Failure to complete the screening will result in a cancelled appointment. Your help in keeping our families, staff and community safe is appreciated!
* Required
Email address
*
Your email
Enter your name or child's name attending
*
Your answer
Enter your phone number
*
Your answer
Are you (or any the children attending family time) currently experiencing a fever of 100, difficulty breathing, or a cough?
*
Yes
No
Have you had any of these symptoms in the last 14 days?
*
Fever greater than 100
Difficulty breathing
Cough
No symptoms
I have symptoms, but my symptoms are not linked to COVID
Required
I have symptoms, but my symptoms are not linked to COVID (Identify symptoms.)
Your answer
Have you had contact with anyone with confirmed COVID-19 in the last 14 days?
*
Yes
No
A copy of your responses will be emailed to the address you provided.
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