COVID-19 Daily Student Screening
This self-certification form must be filled out DAILY. It must be filled out individually for each student. This form must be filled out BEFORE 7:00 AM.
Student Last Name
Student First Name
Please check the boxes that apply. My child
Has a fever (>100.4) AND signs/symptoms of acute illness (e.g. cough, difficulty breathing, sudden loss of taste or smell, sore throat, body aches
Has had close contact with someone with confirmed or suspected COVID-19 within the last 14 days
None of the above
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This form was created inside of Grass Lake School District #36.