Daily Screening of Child - COVID19
Please complete this form before dropping your child off at school. If you have more than one child please complete the form for each child.

If you answer “YES” to any of the questions and the symptoms of your child are not related to a pre-existing condition (e.g. allergies) your child should NOT come to school. The BC Center for Disease Control has stated:

"Students or staff may still attend school if a member of their household has cold, influenza, or COVID19-like symptoms, provided the student/staff is asymptomatic. It is expected the symptomatic household member is seeking assessment by a health-care provider."

If your child is experiencing any symptoms of illness, contact a health-care provider for further assessment. This includes 8-1-1, or a primary care provider like a physician or nurse practitioner.

If your child is absent or sick from school for any reason, please complete a separate an absentee form through our website.

If you only have one child you only complete 1-4 and then skip to the bottom for 5 & 6. The form is set up so that if you have multiple children you can complete the form for all your kids.
1. Name of Parent / Caregiver *
2. Name of Child *
3. Grade of Child *
4. Does your child have any of the following symptoms: Fever, Chills, Cough or worsening of chronic cough, Shortness of breath, Loss of sense of smell or taste, Diarrhea, or Nausea and vomiting? *
Name of Child
Grade of Child
Does your child have any of the following symptoms: Fever, Chills, Cough or worsening of chronic cough, Shortness of breath, loss of sense of smell or taste, Diarrhea, or Nausea and vomiting?
Clear selection
Name of Child
Grade of Child
Does your child have any of the following symptoms: Fever, Chills, Cough or worsening of chronic cough, Shortness of breath, loss of sense of smell or taste, Diarrhea, or Nausea and vomiting?
Clear selection
5. Have you or anyone in your household returned from travel outside Canada in the last 14 days? *
6. Is anyone in your household a confirmed contact of a person confirmed to have COVID-19? *
Submit
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