Millbrook CSD STUDENT Daily Health Screener
Prior to coming to school each day, all students must have their temperature taken AT HOME by a parent/guardian and answer the questions listed below. If your child's temperature is equal to or greater than 100.0 degrees Fahrenheit, or is experiencing any other symptom of COVID-19, your child will not be cleared to enter the building. Symptoms include fever or chills; cough; shortness of breath or difficulty breathing; fatigue; muscle or body aches; headache; new loss of taste or smell; sore throat; congestion or runny nose; nausea or vomiting; and/or diarrhea.

Your participation is important to help us take precautionary measures to keep your child and everyone working in our schools safe and healthy.

We ask that all forms be submitted daily by 7:30 am for entry into the building.

This guidance is intended for screening of students prior to the start of the school day. It is not intended for students with confirmed or suspected COVID-19, including persons under investigation. Individuals with confirmed or suspected COVID-19 should follow the guidance from their physician and CDC guidelines.
1. Student's Name (Last, First) *
2. Date *
3. School *
4. Has your child experienced any symptoms of COVID-19, including a temperature equal to or greater than 100.0 degrees Fahrenheit in the past 14 days? *
5. Has your child knowingly been in close or proximate contact, in the past 14 days, with anyone who has tested positive through a diagnostic test for COVID-19 or has or had symptoms of COVID-19? *
6. Has your child been tested through a diagnostic test for COVID-19 in the past 14 days? *
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