Daily Screening - Students
All parents must self-complete this screening and submit this form by 8 a.m. every day before bringing their student to school.

The school will send home any employee or child who has any new or worsening signs or symptoms of possible COVID-19 starred below. Those with other symptoms listed must meet with Ms. Laufersky to discuss whether they are able to attend school that day.

Source: Texas Health and Human Services/Governor’s Strike Force to Open Schools
https://gov.texas.gov/uploads/files/organization/opentexas/OpenTexas-Checklist-Child-Care-Centers.pdf
Student's Last Name *
Travel disclosure: I, and/or my children, have traveled in the past two weeks. *
If you answered "yes" to the above question, please share the details of your travel, including dates, location, mode of travel (air, car, train, etc), and activities engaged in.
If you have a question about upcoming scheduled or potential travel, please send it to schoolnurse@whiterockmontessori.org.
WRM Social Contract *
Captionless Image
Required
My student(s) will be at school today. *
If you answered no, please tell us why.
Are you or your child/ren experiencing any of the following new or worsening signs or symptoms of possible COVID-19? *
A student will be sent home if they have any of the starred symptoms OR at least two of the unstarred symptoms.
Yes
No
A measured temperature greater than or equal to 100.4 degrees Fahrenheit*
Sore throat*
New uncontrolled cough that causes difficulty breathing*
Diarrhea, nausea/vomiting, or abdominal pain*
New onset of severe headache, especially with a fever*
Body aches
Fatigue
New loss of taste or smell
Known contact with a person who is lab-confirmed or presumed to have COVID-19
Being evaluated or been diagnosed for COVID-19 in the past 14 days
If there is any additional information you would like to share with us about the question above, please do so here.
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