CCS Daily Symptom Checker
This form should be filled out for each staff or student coming on campus each day. No person will be allowed on campus without this form filled out.
Last Name *
First Name *
Grade *
Temperature *
Does this person have any symptoms of COVID-19? (Symptoms may include: fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and/or diarrhea) *
If yes, list symptoms:
In the past 14 days, has this person come into contact with COVID-19? *
In the past 14 days, has this person been out of the country? *
Will this person attend extended care today? *
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