K-8: HNM Health Screening
Must be completed daily before coming to the HNM Campus.
Student's Name (please INCLUDE LAST NAME)
Are you attending school or are you off campus today?
Do you have a fever over 100.4? Be sure to check your individual thermometer for equivalent readings.
Do you have a new cough? (This doesn't include a chronic cough.)
Do you have or had diarrhea or nausea in the last 24 hours?
Have you been around anyone who has tested positive for COVID in the last 14 days
Have you traveled outside of the state in the last 10 days?
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Holy Name of Mary School.