STUDENT COVID SCREENING

To be completed by parent/guardian daily
Email *
Child's Last Name / Apellido del niño: *
Child's First Name / Primero nombre del niño: *
Child's School / Escuela del niño *
Child's Grade Level / Grado del niño *
In the past two weeks have you traveled internationally? / ¿En las últimas dos semanas ha viajado internacionalmente ? *
Has your child had close or proximate (within 6ft for at least 10 minutes) contact with any person with known COVID-19 or person under Investigation for COVID-19? / ¿Su hijo ha tenido contacto cercano (dentro de los 6 pies durante al menos 10 minutos) con alguna persona con COVID-19 conocido o persona bajo Investigación por COVID-19? *
Is your child's temperature at or above 100.0? (if it is then they must stay home) / ¿Su temperatura es igual o superior a 100,0? (si es así, debe quedarse en casa) *
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