FUFSD Student (In-Person) Health Screening Questionnaire- Weekly
Parents,
Any student participating in in-person instruction is required to complete this form by 9:00am of the first school day of the week. Temperature checks are required. Anyone who has a temperature of 100 degrees F or greater is not allowed entry into a district facility.
Email *
Child's First Name *
Child's Last Name *
Parent/Guardian Cell Number or Contact Number *
School Child Attends: *
Has your child knowingly been in close or proximate contact in the past 14 days with anyone who has tested positive for COVID-19 or who has or had symptoms of COVID-19? *
Has your child tested positive for COVID-19 in the past 14 days? *
Take your child's temperature before answering this question. Has your child experienced any symptoms of COVID-19 in the past 14 days? According to the CDC, possible symptoms may be: fever (greater than 100 degrees F) or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea, vomiting, diarrhea, unexplained rash or pink eye. Anyone who has a temperature of 100 degrees F or greater is not allowed entry into a district facility. *
Has your child traveled to a noncontiguous state, US territory or CDC level 2 or level 3 country within the last 14 days? For current information regarding travel outside of NYS, please visit https://coronavirus.health.ny.gov/covid-19-travel-advisory *
Face coverings and social distancing are required. Please submit this form by 9:00am of the first school day of the week. Thank you!
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