PTA Volunteer and Parent Participation COVID-19 Required Screening Form
This questionnaire must be filled out by any parent or guardian volunteering for an approved, in-person PTA event, as well as any parent or guardian who is attending an event with or without his/her child.

Please fill this form out on the day of the event, only.  
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Last Name     *
First Name *
Email *
Phone *
School in which event is for: *
School event you are volunteering for or attending in-person:   *
Please perform a self-evaluation and select any of the COVID-19 symptoms listed below (defined by the CDC). Do you have any of the following symptoms? Have you experienced any of these symptoms in the last 14 days? *
No
Fever
Shortness of breath or difficulty breathing
Cough
Sore throat
Headache
Gastrointestinal symptoms (diarrhea, nausea, vomiting)
New nasal congestion or runny nose
New loss of smell
New loss of taste
Chills
Body or muscle aches
Fatigue/lethargy
Are you  under active quarantine for COVID-19 purposes? *
If you answered as having any of the listed COVID symptoms and/or answered YES to the quarantine question above, you may not attend today's in-person event as a volunteer or participant. *
Required
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