COVID-19 Survey
Please answer the following questions based on the CDC’s Travel Guidance (cdc.gov/coronavirus).
Email address *
Parent Name *
Your answer
Student(s) Name(s) *
Your answer
Do you have underlying health issues that would make you more vulnerable or put you at greater risk of infection from COVID19? (i.e. older adults, people with heart disease, diabetes, lung disease) * *
Have you been in close contact with people who have traveled to countries where COVID19 is spreading within the past 14 days? *
Do you have a fever, or have you had a fever within the past week? *
Have you been nauseated or have you vomited or had diarrhea within the past week? *
Have you travelled outside of the country in the last month? *
IF YOU HAVE MARKED YES TO ANY QUESTION; PLEASE DO NOT ENTER TWISD FOR AT LEAST 14 DAYS AFTER THE START OF YOUR SYMPTOMS. Contact your healthcare provider if your symptoms get worse. Thank you for understanding.
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