Daily Self-Screening Questionnaire
Dear Parent(s) or guardian:

Please complete this COVID-19 Self-Screening Questionnaire everyday for/with your child(ren). If you have more than one child, you will have to complete a separate questionnaire for all of your children. For example, if you have two children, you will have to complete this questionnaire twice.

This self-screening will help to minimize risks to our school population. Gobind Sarvar is following a "Strict At Home Policy", so if you answer yes to any of the questions, it is recommended that you keep your child home that day. If you answer no to all of the questions, then your child may come to school.

Thank you for your support.
Gobind Sarvar School Administrative Team
What is your child's name? (First and Last Name) *
What Grade is your child in? *
Self-Screening Questionnaire
Please read the following questions.

If you answer YES to any of these questions - please DO NOT send your child to school.

If you answer NO to all of these questions - your child may attend school. Thank you!
Please check the box below to confirm that you have read through the COVID-19 Self-Screening Questionnarire. *
Thank you!
Thank you for completing the COVID-19 questionnaire. Please complete this questionnaire daily.
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