Trimpe Middle School_COVID-19 Daily Facility Entry Questionnaire
BCUSD8 is committed to continuing to serve our students, parents, and community during the COVID-19 pandemic.

Please read and complete the below questionnaire each day prior to entry into any BCUSD8 facility. You may complete this up to 4 hours before your day begins.

If you answer YES to any of the below questions, please do not enter the building and contact Human Resources immediately at 618-377-7200, 618-781-5318, or kmcclain@bethalto.org. There is an additional form to submit as well.

Central Office will maintain these records confidentially.

If you answer, YES, to any of the below questions... do NOT report to work! Enter the information below
Email address *
Employee First Name *
Employee Last Name *
Please respond yes or no to the following questions. IF YOU ANSWER YES, YOU SHOULD NOT REPORT TO WORK. *
Yes
No
Do you have a temperature over 100.4?
Are you taking fever-reducing medicines, such as those that contain aspirin, ibuprofen or acetaminophen, in order to reduce your fever?
Have you been directed to self-quarantine by a health care provider or health department?
Have you tested positive for COVID-19?
Are you experiencing ANY of the following symptoms? IF YOU ANSWER YES, YOU SHOULD NOT REPORT TO WORK.
Is anyone in your household awaiting the results of a COVID-19 test? IF YOU ANSWER YES, YOU SHOULD NOT REPORT TO WORK. *
Best Personal Contact Phone Number
ATTENTION!!!!
If you answered, YES, to ANY of the above questions, do NOT report to work until you are cleared to return. Please also complete the Employee Self-Reporting form: https://forms.gle/KuFbmYmXvqD2txt38 You can leave any additional comments below.
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