MCS Student Daily Health Screen

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Please complete the health screening each time your child/ren are scheduled for school. Please fill out for each individual child. Given that the health and well-being of our MCS students and families are our main priority, please keep your child/ren home if they have a temperature of >100.4 or are showing symptoms. Please notify the school if you need assistance.

Please fill in student's name: *

Today's date: *

YYYY

Time of temperature check and health screen: *

Time

Temperature recorded: *

Please indicate in your child is showing any of the following symptoms. *If no symptoms are present, select NO SYMPTOMS at the bottom. *

Cough

Shortness of breath or difficulty breathing

Fever

Chills

Muscle pain

Sore throat

Loss of smell or taste

Fatigue

Headache

Runny nose

Nausea

Vomitting

Diarrhea

Diagnosed allergy symptoms

NO SYMPTOMS

Other:

Required

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