Student Weekly Check In
A weekly heath screening is required by St. Mary's Elementary School in order for students to be allowed entrance into the building each Monday. Please complete this form by Sunday evening. Please complete a separate form for each child you have in school.
Today's Date *
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Student's Last Name *
Student's First Name *
Parent's Name *
Parent Email Address *
What grade is your child in? *
Does your child have a temperature greater than 100⁰F? * *
Does your child feel well today? *
Required
Has your child come in close, regular contact (within 6 feet) of someone who has a laboratory confirmed COVID-19 diagnosis within the past 14 days? *
Does your child have any of the following: fever or chills, cough, shortness of breath or difficulty breathing, body aches, headache, new loss of taste or smell, sore throat? *
Has your child traveled to any of the states on currently on the Advisory List in the last 14 days? *
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