BVSD COVID Screening Form
You must complete this self-screening assessment before you report to work at BVSD.  If you answer yes to any of the health questions below or your temperature is 100.0° F or higher, you may not work. You should contact your supervisor and/or COVID Coordinator for next steps.
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Name *
What department do you work in? *
What school or building are you going to? *
Required
Do you currently have a temperature of 100.0 degrees or higher or feel feverish? *
You should take your temperature if able.  Feverish - feeling chills or being warm to the touch
In the last 2 days (48 hours) have you had a temperature over 100.0 or felt feverish? *
Feverish - Feeling chills or being warm to the touch
In the last 48 hours have you experienced a new or worsening cough? *
In the last 48 hours have you experienced any new or worsening shortness of breath? *
In the last 48 hours have you experienced any of the following symptoms a loss of taste or smell, fatigue, muscle/body aches, headache, nausea/vomiting, or diarrhea? *
In the last 14 days have you had close contact with anyone who has symptoms of COVID-19 or been diagnosed with COVID-19? *
Close contact is someone living in your household or who you've been within 6 ft of for 15 minutes or more.
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