COVID-19 Self Assessment
Please respond to the following questions to ensure the safety of all those working and visiting Midland Public Schools. Your responses will be reviewed by the MPS HR Department
Enter your full name
Have you been diagnosed with COVID-19 in the last 14 days?
Have you been in close contact with anyone diagnosed with COVID-19 in the last 10 days?
Are you currently experiencing COVID-19 symptoms, including any of the following: new uncontrolled cough, shortness of breath, sore throat, loss of taste or smell, muscle aches, new onset of severe headache, diarrhea, vomiting, or abdominal pain?
Do you have a fever of 100.4 degrees Fahrenheit or higher?
What building(s) will you be working in or visiting?
Adams Elementary School
Carpenter Pre-Primary Center
Central Park Elementary School
Chestnut Hill Elementary School
H.H. Dow High School
Jefferson Middle School
Juvenile Care Center
Maintenance / Grounds Building
Midland High School
Northeast Middle School
Plymouth Elementary School
Science Resources Center
Siebert Elementary School
Woodcrest Elementary School
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Midland Public Schools.