Hawthorne Elementary School Visitor Log
In addition to mandatory mask wearing and 6 ft physical distancing, please complete this form before physically stepping on any BHUSD property. If you do not pass the Health Screening or your temperature measures 100.4°F or higher you cannot come to campus.

Visitors are by appointment only and are preregistered in a visitor log that includes a visitor’s name, phone number and email address.

Visitors to the school other than parents of enrolled students are limited to those who are essential for the school’s operation.

Visitors are instructed to come to their appointments alone. If a visitor must be accompanied by another person
(e.g., for translation assistance, or because the visitor is a minor, or has minor students) their information is captured in the visitor log.
Visitor's First Name *
Visitor's Last Name *
Phone Number (xxx-xxx-xxxx) *
Email Address *
Do you have any of the following? Cough, Shortness of Breath, Difficulty Breathing, Fever, Chills, Or Other Symptoms *If you answer yes you have not passed the Health Screening, you are not permitted to enter any BHUSD premises. * *
I have taken my temperature today and it is not 100.4 or above * *
Within the past 14 days, have you had contact with anyone that you know had COVID-19 or COVID-like symptoms? Contact is being 6 feet (2 meters) or closer for more than 15 minutes with a person, or having direct contact with fluids from a person with COVID-19 (for example, being coughed or sneezed on). * *
Have you had a positive COVID-19 test for active virus in the past 10 days? *
Within the past 14 days, has a public health or medical professional told you to self-monitor, self-isolate, or self-quarantine because of concerns about COVID-19 infection? * *
I confirm that the information given in this form is true, complete and accurate. * *
Signed (your name) * *
If you do not pass the Health Screening or your temperature measures 100.4°F or higher you cannot come on campus.
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