COVID-19 Student Daily Health Screening Form
This brief screening form must be completed prior to sending your student to school. This form must be completed EACH DAY your student comes to school in person.
Sign in to Google to save your progress. Learn more
Choose your student's building: *
Please enter your student's first and last name *
Please enter your student's grade *
Please enter your full name *
Please enter your phone number *
Please enter your home e-mail address (double check for accuracy). *
Does your child have ANY of these symptoms that are new, different, or worse than any long-standing conditions: (1) Temperature at 100.4°F or above, or signs of fever (chills, sweating) without the use of fever-reducing medication, (2) Sore throat, (3) New uncontrolled cough that causes difficulty breathing, (4) Diarrhea, vomiting, or unusual abdominal pain, (5) New onset of severe headache, or (6) New loss of taste or smell? *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Muskegon Public Schools. Report Abuse