Southmont Schools Covid-19 Symptom Screener
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Are you completing this questionnaire for yourself or for someone else? *
What is the LAST NAME of the quarantined child or staff member? *
What is the FIRST NAME of the quarantined child or staff member? *
Is the quarantined person a student or a staff member? *
What is today's date? *
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With which school is the quarantined child or staff member affiliated? *
Has the child or staff member experienced any of the symptoms in the last 24 hours? Check all that apply. *
Required
Is the quarantined person currently waiting on the results of a Covid-19 test? *
If the quarantined person is currently waiting on the results of a Covid-19 test, what date was the test administered?
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