COVID Screening Questionnaire
This form MUST be completed each day you are entering the building. We recommend you have your child take the questionnaire before they leave to school because If they fail it they will not be allowed to attend school that day.
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Email *
Student First Name Below: *
Student Last Name Below: *
Are you considered fully vaccinated against COVID-19 by CDC guidelines OR were you recently (within the past three months) diagnosed with COVID-19 and finished isolation in the past 90 days? Please note that to be considered fully vaccinated by CDC guidelines, two weeks must have passed since you received the second dose in a two-dose series or two weeks must have passed since you received a single-dose vaccine. *
To best of your knowledge, in the past 10 days, have you been in close contact (within 6 feet for at least 10 minutes over a 24 hour period) with anyone who is currently diagnosed with COVID-19 OR who has been told they have symptoms of COVID-19? Clinical staff who were in appropriate personal protective equipment (PPE) are not considered close contacts in these scenarios. *
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