COVID Self-Screening Assessment-Students
This form MUST be completed each morning before your child comes to school. Please complete for each child if they are attending in-person instruction that day.
Student's First Name
Student's Last Name
Sanford High School
Sending School SRTC Student
Carl J. Lamb School
Margaret Chase Smith School
Sanford Middle School
Does your child have any of the following symptoms that are unexplained or different from your known health conditions?
Fever of 100 degrees or higher
Chills or repeated shaking with chills
Difficulty breathing/shortness of breath
Unexplained muscle aches
New loss of smell or taste
New runny nose or nasal congestion (different from your normal allergies or seasonal fever)
Vomiting or diarrhea in the last 24 hours
Has your child been diagnosed with COVID-19 in the past 28 days?
Does your child live with someone who has been diagnosed with COVID-19 or is still symptomatic in the past 14 days?
In the past 14 days has your child traveled outside the US or outside Maine, excluding NH, VT, CT, NY, or NJ?
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This form was created inside of Sanford School Department.