Preschool Owen CKS Daily Health Questions: Over last 24 hours has this person experienced any of the following symptoms?

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Please answer each of the questions below each day with your child before having your child's temperature checked by school staff. If any answer is YES, the person is not allowed on campus. One form is needed per child. Please contact Karen Watkins at 206-931-5712 if there is a YES answer or if you have a child with a symptom, so Karen can review with you our protocol for when/how it is safe to return to school.

Parent's Name that will be dropping child off today: *

Child's Name *

Has the child travelled outside of Washington State recently and needs to still complete quarantine time? CKS asks that you follow the Governor's recommendation to quarantine for 7 days after return and get a COVID-19 test on day 3-5 of quarantining or quarantine for 10 or 14 days after return without a COVID-19 test. *

Yes

Does anyone in your household have any illness symptoms? If so, all children need to stay home and participate in distance learning. *

Yes

A fever of 100.4°F or higher or a sense of having a fever? *

Yes

A cough that you cannot connect to another health problem? *

Yes

Shortness of breath that you cannot connect to another health problem? *

Yes

A sore throat that you cannot connect to another health problem? *

Yes

Muscle aches or body aches that you cannot connect to another health problem or to another activity such as physical exercise? *

Yes

Chills? *

Yes

Headache? *

Yes

A new loss of taste or smell? *

Yes

Nausea or vomiting? *

Yes

Diarrhea? *

Yes

Congestion or a runny nose not related to seasonal allergies? *

Yes

Unusual fatigue? *

Yes

Had any medication to reduce a fever before coming to care? *

Yes

Has this person been in close contact with anyone suspected of or laboratory-confirmed with COVID-19 (6 feet or closer for at least 15 minutes or sessions adding up to 15 minutes in a 24 hr period)? *

Yes

Has this person been isolating or quarantining because they may have been exposed to a person with COVID-19 or are worried that they may be sick with COVID-19? *

Yes

Is this person currently waiting on the results of a COVID-19 test? *

Yes

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