Guest Symptom Questionnaire
This form must be completed prior to entering any school/district facility. No exceptions will be made.
Sign in to Google
to save your progress.
Have you had any of the following symptoms in the past 3 days? (check all that apply)
Fever 99.5 F or above
New shortness of breath
New loss of taste and or smell
New muscle aches
Congestion or runny nose
No, I have not had any of the symptoms above in the past 3 days
Have you been around someone with COVID-19 or any of the symptoms above?
Never submit passwords through Google Forms.
This form was created inside of South Whittier School District.