Student Check In
This form must be filled out each Sunday, prior to entering the building on Monday.
Email *
Today's Date *
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Parent's Name *
Student First Name *
Student Last Name *
Homeroom Teacher *
Does your child have a temperature greater than 100.0⁰F? *
Does your child feel well today? *
Has your child come in close, regular contact (within 6 feet) of someone who has a laboratory confirmed COVID-19 diagnosis within the past 14 days? *
Does your child have any of the following: 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, diarrhea, or any other signs and symptoms of illness. *
Has your child been tested NEGATIVE for COVID-19 in the past week? *
Has your child traveled to any of the states on currently on the Advisory List in the last 14 days? *
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