KKCS Screening Survey
The following is a survey to determine if your child is allowed to be in the KKCS premise today in order to help combat COVID-19 pandemic and keep our staff and students safe. Please answer these questions as truthfully as possible. When you are done, you will receive an email receipt. Please show this email at the reception to ensure a smooth process.
Student Full Name 學生姓名
Today’s Date 日期
What was your measured temperature today? 今天的體溫是多少？
Are you currently experiencing, or have you experienced in the past 14 days, any of the following symptoms? 你現在或者14天內有沒有感受到以下的症狀？
Fever (100.4° F/37.8° C or greater as measured by an oral thermometer) 高燒（華氏100.4度或者攝氏37.8度）
Shortness of breath or difficulty breathing 呼吸困難
Sore throat 喉嚨痛
New loss of taste or smell 失去味覺或嗅覺
Head or muscle aches 頭疼或肌酸
Gastrointestinal symptoms (diarrhea, nausea, vomiting) 腹瀉或嘔吐
Unexplained rash 不明來歷的皮疹
None of the above 沒有
In the past 14 days, have you been in close proximity to anyone who was experiencing any of the above symptoms or has experienced any of the above symptoms since your contact? 你14天內有沒有與有以上的症狀的人有接觸或者接觸後你自己有沒有感受到那些症狀？
In the past 14 days, have you been in close proximity to anyone who has tested positive for COVID-19? 你14天內有沒有與患有新冠肺炎的人有接觸？
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Kwong Kow Chinese School.