Lindbergh Parent Commitment for Student Screening
*Please complete this form for each student that you have in attendance at Lindbergh Elementary. (For example, if you have 2 students at Lindbergh, 2 separate forms will need to be completed).
Hello Lindbergh Families,
For the health and safety of our students, the local public health department requires students to be screened for symptoms of COVID-19 before entering the school building. The local public health department and CDC do not recommend that on site screening be conducted by schools due to the time and interruption to education this would cause. You must complete the steps of the student screening prior to sending your child to school, school activities, or sports. Click the link below to read through the student screening tool that must be completed each time the student enters the school building:
Please enter the student's full name (first and last)
Please select the student's current teacher
Ruselink (young 5's)
By typing my full name (first and last) in the space below, I am committing to using the Student Screening Tool to screen my child daily for the 2020-2021 school year, unless otherwise directed. I will also ensure that I and any visitors with me will wear face coverings whenever required to do so. I also understand that it is my responsibility to call Lindbergh Elementary School as soon as possible to let them know if my child is not going to school due to potential COVID-19 symptoms. I commit to screening my child (named above) for COVID-19 symptoms and exposure, and agree to follow the guidance as outlined on the screening tool.
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Dearborn Public Schools.