Daily Health Attestation - Giving Tree School
Please complete for each day your child attends school. If you answer yes to any of the following, do not bring child to Giving Tree, and please call or text to notify us - 413-768-2450.
Name of Child *
Today's date *
MM
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DD
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YYYY
Best contact number today *
Have you observed any of the following symptoms in your child or another household member during the past 24 hours?
Fever of 100.0 degrees Fahrenheit or higher? *
Cough? *
Sore Throat? *
Rapid breathing or difficulty breathing (without recent physical activity)? *
Gastrointestinal symptoms (diarrhea, nausea, vomiting)? *
Fatigue (fatigue alone should not exclude a child from participation)? *
Headache? *
New loss of smell or taste? *
New muscle aches? *
Any other sign of illness? *
Within the last 14 days, have you or your child had close contact with a COVID-19 positive individual? *
Please list where your child has been (excluding their primary residence) since they were last at Giving Tree. *
If you answered "yes" to any of the above questions, do not bring child to school, and call or text to notify us: 413-768-2450.
If you have questions about whether it is appropriate to return to school, please refer to our quick reference flowchart for symptoms of illness: https://drive.google.com/file/d/1bQ0L-w6lnqYqA6hPb3jw8iQWeB_oJNqh/view?usp=sharing
Parent/guardian signature *
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