Sharon Community Education Daily COVID-19 Health Screening
Complete this form each day that your child will attend a Community Education program. You may complete the form up to 12 hours prior to their attendance but not earlier. The form is timestamped. Students will not be able to attend a Community Education program without this daily form completed and verified by staff.
Fill out one form per day per child.
What school does your child attend?
In the past 24 hours have you or any household members exhibited any of the following symptoms?
A fever (100.of or above), felt feverish or had chills
A cough (not previously diagnosed)
Difficulty breathing (not previously diagnosed)
Diarrhea, nausea, vomiting
Loss of smell or taste
Other signs of illness
None of the above
In the past 14 days have you had close contact with a person known to be infected with COVID-19?
I attest that I have been truthful in answering these questions and that to my knowledge no member of my household has had contact with COVID-19 or has COVID-19 symptoms, nor has my child been given medicine to lower a fever. I understand that should my child have exhibit any symptoms, I will not send my child to a Community Education program without symptoms abating, (fever free with out medicinal aid for 72 hours), my child being cleared by testing, or clearance from their health care provider.
By checking this box I agree that the above statement is true.
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This form was created inside of Sharon Public Schools.