Discovery Preschool Daily Covid-19 Screening
This form is to be completed daily by the parent/guardian by 8:30 am daily. Only children with "no" answering will be allowed to attend school that day.
* Required
Email address
*
Your email
Date:
*
MM
/
DD
/
YYYY
Child's first and last name:
*
Your answer
Parent's first and last name
*
Your answer
Does your child have a fever?
*
Yes
No
Does your child have a cough?
*
Yes
No
Does the child have Shortness of Breath/Difficulty Breathing?
*
Yes
No
Has the child recently experienced a loss of sense of taste or smell?
*
Yes
No
Is the child Feeling unwell/Fatigued?
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Yes
No
Does the child have Nausea/Vomiting/Diarrhea?
*
Yes
No
Has the child, or anyone in your household, travelled outside of Canada in the last 14 days?
*
Yes
No
Has the child had close *unprotected contact (face-to-face contact within 2 meters/6feet) with someone who is ill with cough and/or fever?
*
Yes
No
Has the child or anyone in your household been in close *unprotected contact in the last 14 days with someone that is being investigated or confirmed to be a case of COVID-19?
*
Yes
No
Disclaimer
If you have answered “Yes” to any of the above questions, your child MAY NOT enter at this time.
Our goal is to minimize the risk of infection to our staff, children, and their families thank you for your understanding and cooperation.
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