Legacy Marching Band Health Self-Screening Form
To use this form, take your student’s temperature and check the symptoms listed below every day before reporting to practice. If your student has underlining health conditions, such as allergies that cause them to have a runny nose, frequent nausea due to food allergies, etc, please let Mr. Stansberry and the school health aide know. However, if they have any of the symptoms below that are outside of their normal baseline, keep your child home and notify Mr. Stansberry of the absence. Anyone experiencing symptoms outside their normal baseline should get tested, stay away from others, and quarantine. Symptomatic students must follow the new public health guidance before returning to school. The new guidance is:

● A student may return 24 hours after their symptoms begin only if their symptoms have completely resolved.

*Please notify the school and Mr. Stansberry if your student tests positive for COVID-19.

Answer YES or NO to the following symptoms below.

Para usar este formulario, tiene que tomarse la temperatura y revisar sus síntomas todos los días antes de reportarse a su trabajo. Si tiene alguna condición de salud previa, como por ejemplo alergias que causan que tenga secreción nasal, no tiene que reportarlo a su supervisor. Sin embargo, si tiene algunos de los síntomas mencionados abajo y son síntomas que regularmente no tiene, notifíquelo a su supervisor inmediatamente para saber qué tiene que hacer antes de reportarse a trabajar. Cualquier persona con síntomas que no son parte de una condición previa, debe hacerse una prueba, mantenerse lejos de otras personas y aislarse. Empleados con síntomas tienen que seguir las nuevas normas de salud pública antes de regresar al trabajo. Las nuevas normas son:

● Puede regresar cuando no tenga síntomas y no haya tenido fiebre sin tomar medicamento por lo menos por 24 horas.

*Por favor, notifique a la escuela si su hijo tiene un resultado positivo en la prueba de COVID-19
Student Last Name/Apellido: *
Student First Name/Nombre de pila: *
Instrument: *
September Cohort Number *
In the past 14 days have you been in close contact (within 6 feet for at least 15 minutes total) with a person with a confirmed diagnosis of COVID-19 or have you tested positive for COVID-19? *
In the past 24 hours, have you had any of the following symptoms (Check any that apply - ***If you have any symptoms you are NOT allowed to attend practice.) *
Required
Is your current temperature 100.4 °F or greater? Fiebre de100.4° o más? *
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