Daily Health Self-Screening (Covid-19)
This form must be completed daily BEFORE coming to the Providence Catholic School campus until further notice. Updated Symptoms: July 20, 2020

Refer to PCS Operational Plans (Covid 19)

Health Screening Procedures
1. Daily screening must occur of all individuals on campus or those conducting a PCS sanctioned
activity.
2. Staff, students and visitors will be required to complete a self-screening health check online. This form must be checked daily for clearance.
3. All visitors must sign in at the front office. We invite you to come on campus during school hours 7:30am to 4pm, but we prefer you call and set up an appointment if you need to meet with anyone on our staff.
4. All shall wear a face covering while in the building.
5. Middle School Students and High School Students must follow check in and screening procedures and use designated entrances.
6. Students must receive a temperature check by a designated administrator. Temperature must be below 100.4 to participate in any activities. Visitors receive temperature check at the front office window.
7. Any person who does not pass this screening will be sent home immediately. If they are unable
to leave campus immediately, the individual must be isolated until the individual is able to leave.

Please select YES if you have experienced any of the following symptoms in the last 24 hours. If you select YES, please do not come to campus or another PCS sanctioned summer activity.

If you will be absent from school in-person or online, please call 210-224-6651 x 200 to report an absence.

Any person who has come on campus must report if tested for Covid-19, experiencing symptoms or come in close contact with a positive case may not come on campus. Call 830-719-4711 to report any case after coming onto campus or attending a PCS activity. An individual's medical information is private and confidential. This phone line is designated specifically for Covid reports in order to expedite a communication response as efficiently as possible for the health and safety of all in our community.

Last Name (Student, Parent, Visitor) *
First Name (Student, Parent, Visitor) *
What PCS activity do you need to submit this form for today? (If you are participating in more than one activity in a day, please select the FIRST activity you will arrive for.) If you are participating in an Athletic activity, you must submit a different form. *
Please select YES if you have any of the following symptoms: Cough, Shortness of Breath, Chills, Repeated shaking w/ chills, Muscle pain or body aches, Headache, Sore Throat, New loss of taste or smell, Congestion or running nose, Nausea or vomiting, Diarrhea, or Feeling feverish with a measured temperature of 100.4 or greater. *
Known close contact with a person who is lab confirmed to have Covid-19. (Close contact is defined as being within 6 feet of someone who is positive for 15 minutes or more.) *
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