COVID-19 (Coronavirus) Survey
Complete One (1) Survey per Family
Last Name, First Name (All School Age Students) *
Your answer
Update Contact Information (Address, Phone Number) *
Your answer
Grade Level (s) *
Your answer
Do you have Internet Access? *
Do you have a technology device? Check all that apply *
Required
Have you or a household family member traveled outside the U.S. in the last 2 weeks? *
Have you or a household family member traveled outside the State of Texas in the last week? *
If you traveled outside the U.S. or the State of Texas, where did you travel?
Your answer
Have you or a household family member been in direct contact with someone who has been diagnosed with COVID-19 (Coronavirus)? *
Should school be closed beyond March 24, would you pick up free breakfast / lunch for your children enrolled in Riviera ISD?
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