2021-22 Daily Health Questionnaire
Centreville Preschool, Inc
Email *
What is your child's name? *
Which class does your child attend today? *please check only TODAY'S class* *
Has your child, or anyone in the household, had any of the following symptoms in the last 72 hours? *
Has there been any use of fever reducing medication within the last 72 hours? *
Within the past 14 days, have you/your child been in close physical contact with a person who is known to have laboratory-confirmed COVID-19 or with anyone who has any symptoms consistent with COVID-19? *
Is anyone in the household currently waiting on the results of a COVID-19 test? *
Do you need to speak to the Health and Safety person today for clarification regarding possible symptoms or concerns? *
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