Daily Self-Screening Checklist
Complete the Daily Self-Screening Checklist prior to entering any Webster Groves School District building.
Email address *
If you are a Webster Groves School District employee and answer YES to ANY of these questions, do not report to work and immediately contact your direct supervisor.
If you are a guest of Webster Groves School District and answer YES to ANY of these questions, immediately leave the facility and follow the protocol established by your employer and/or health care provider.
First Name and Last Name
Do you have a new fever of 100.4 or greater?
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Building
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Are you currently experiencing diarrhea symptoms?
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Are you currently experiencing congestion and/or runny nose?
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Are you currently experiencing nausea or vomiting?
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Do you have a new cough that you cannot attribute to another health condition?
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Are you currently experiencing shortness of breath or difficulty breathing that you cannot attribute to another health condition?
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Are you currently experiencing any loss of taste or smell?
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Are you currently experiencing a headache that you cannot attribute to another health condition?
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Do you have new muscle or body aches that you cannot attribute to another health condition or that may have been caused by a specific activity (such as physical exercise)?
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Are you currently experiencing a fever or chills?
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Have you had any close contact with a person who demonstrated any of the above symptoms?
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Have you had any close contact with a person who has a suspected or confirmed case of COVID-19?
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Have you been tested for COVID-19 and are awaiting results?
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Have you tested positive for COVID-19?
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Have you traveled outside the United States by air or cruise ship in the past 14 days?
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If yes, please list the date(s).
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