Eldred Student COVID-19 Building Entrance Screening Questionnaire
Please complete this questionnaire EACH day that your child is planning on attending school. This form should be completed for EACH child every morning before your child leaves for school.

Thank you for your cooperation and assistance.
Student's First Name *
Student's Last Name *
Please indicate the day for which you are submitting this form *
Please Note: You should fill this questionnaire out each day your child is planning on coming to school. Thank you
Required
Destination(s) please check all that apply *
Required
If you checked "Yes" to one or more of these questions, your child is NOT permitted to come to school. Please contact your building principal for further instructions. Thank you
Does your child feel feverish or have any symptoms known to be associated with COVID-19 in the past 14 days including a temperature of 100.0 degrees Fahrenheit or greater? *
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