COVID-19 Questionnaire Downey Band/Guard
All district employees and public visitors are responsible for following all state, county, local and District health guidelines as well as required safety measures including the wearing of required mask and social distancing while on the school site. All employees and public visitors are required to complete a COVID-19 Health Screening Assessment when in-person at the school site.
Last Name *
First Name *
Activity *
Have you had a fever (100.4 F or higher) and/or cough while sick and/or difficulty breathing in the last 72 hours? *
Have you taken fever-reducing medications (like, but not limited to, Tylenol, Advil, or Motrin) while having a fever in the last 72 yours? *
To the best of your knowledge, have you been exposed to anyone confirmed with Coronavirus in the last 14 days or who have been tested due to exhibiting symptoms? *
Have you experienced recent loss of taste or smell? *
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