Please complete this form each day prior to coming to campus. You will not be allowed to participate in activities on campus without completing and passing this health screening.
Sign in to Google to save your progress. Learn more
Email *
Student last name *
Student first name *
Grade *
My family and I have read and we agree to uphold the Aardvark Community Agreements to prevent the spread of COVID-19. https://www.flipsnack.com/oregonepiscopalschool/oes-community-agreements-2021/full-view.html  *
Why are you coming to campus today? (Please select all that apply) *
If you will be participating in athletics, please check which sport:
Please take your temperature and check the answer that applies: *
Symptoms of COVID-19 include, but are not limited to, the following symptoms. Please consider carefully whether you currently have, or you have experienced within the past 24 hours, any of the following:
- Chills or fever of 100.0 F or higher
- New loss of smell or taste
- Cough
- Muscle or body aches
- Fatigue
- Sore throat
- Congestion or runny nose
- Shortness of breath or difficulty breathing
- Rash
- Headache
- Nausea, vomiting, and/or stomach pain
- Diarrhea
- Loss of appetite

I am fully vaccinated (at least 2 weeks past the final injection) *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Oregon Episcopal School. Report Abuse