Daily Health Screening Assessment
Must fill out daily before entry into childcare.
Your First Name *
Your Last Name *
Have you or your children had any COVID-19 symptoms in the past 14 days? *
Have you, your children, or anyone in close contact with you had a suspected or confirmed COVID-19 case in the past 14 days? *
Have you taken the temperature of each member of your household today and each reading was below 100 degrees? *
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