North Collins CSD Daily Student Screening
𝐓𝐡𝐢𝐬 𝐬𝐜𝐫𝐞𝐞𝐧𝐢𝐧𝐠 𝐦𝐮𝐬𝐭 𝐛𝐞 𝐟𝐢𝐥𝐥𝐞𝐝 𝐨𝐮𝐭 𝐨𝐧𝐜𝐞 𝐩𝐞𝐫 𝐬𝐭𝐮𝐝𝐞𝐧𝐭
*If you answer YES to one of the questions or if your child presents with symptoms of COVID, please call the school nurse to inform them and keep your child home.
Please enter your student's North Collins username up until the @. This is the username he or she uses to log into their Chromebook. For example Jane Smith who graduates in 2025 would be: 2025jasmith **You must enter only 1 student per form**
Read the following screening questions and answer below
Appendix A: Health Screening Questionnaire
COVID-19 HEALTH QUESTIONNAIRE
1) Have you experienced symptoms of COVID-19 such as fever (temperature of 100°F or above) or chills, muscle or body aches, cough, shortness of breath or difficulty breathing, fatigue, headache, sore throat, nasal congestion or runny nose, nausea or vomiting, diarrhea, or new loss of taste and/or smell in the past 10 days? Please answer “yes” only if you are experiencing a new onset of symptoms OR you are experiencing a change in symptoms from your baseline if you have a known pre- existing medical condition (e.g. asthma, allergies).
2) Is your temperature 100 degrees Fahrenheit or greater today?
3) Have you tested positive for COVID-19 in the past 10 days?
4) Have you had contact with anyone confirmed or suspected of having COVID-19 in the past 10 days?
*If you checked YES to any of the above questions, please STOP
and notify administration immediately*
Mark your answer to the above questions:
I can answer YES to one or more of the above questions (*if you answer yes, please keep your child at home and inform the school nurse)
I can answer NO to all of the above questions
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This form was created inside of North Collins Central School District.