TISD Fine Arts Summer Student Health Screening
Student First Name
Student Last Name
Are you or anyone in your immediate family (people you live with) experiencing any of the following symptoms? (Check all that apply)
Shortness of breath
Repeated shaking with chills
Loss of taste or smell
Feeling feverish or a temperature greater than or equal to 100.0° Fahrenheit
Known close contact with a person who is lab confirmed to have Covid-19
None of the above symptoms
I understand that Indicating “YES” to any of the above signs / symptoms will require further evaluation to determine if the student may participate.
What instrument do you play (Kittens - just select "Kitten")
Send me a copy of my responses.
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This form was created inside of Temple Independent School District.