Student Health Check Form
Name (First & Last)
Which grade
In the last 24 hrs have you been in contact with anyone with a known case of COVID-19 virus?
Clear selection
Have you traveled out of state or county within the last 24 hrs?
Clear selection
Please record your temperature
Do you have any of these symptoms that are not caused by another condition?
If you answered yes to any symptoms, have a temperature of over 100 degrees F, or if exposed to a COVID positive person, please stay home. Thank you for keeping our community safe.
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