Parent Daily Screening Survey
Please complete this daily survey prior to coming to K2E. If you have more than one child who attends K2E, please fill out a separate form for each child.
Child's Name *
Date: *
MM
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DD
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YYYY
Have you, your family member or your child come in close contact with a person diagnosed Covid-19 in the past 14 days? *
In the past 24 hours, have you or any household members (including your child) had any of the following symptoms? *
Required
Have you given your child medicine to lower a fever in the past 12 hours? * *
By entering your full name in the box below, you are effectively providing your signature, and attesting that all the information on this form is true and accurate, to the best of your knowledge. * *
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