COVID Daily Questionnaire
Due to the Covid-19 pandemic, parents/guardians of Eden Central School students must fill out the form below. This form must be done every school day to meet Erie County guidelines for COVID monitoring and school attendance.
The district will keep your daily responses on file until further notice. Thank you for complying with these guidelines.
Sign in to Google
to save your progress.
Please enter the student USER NAME for the student this form is for (Student USER Name can be found in Parent Portal)
Please read the statements below as a reference for state required COVID and ATTENDANCE record keeping.
1. Have you experienced symptoms of COVID-19 such as fever (temperature of 100°F or above) or chills, muscle or body aches, cough, shortness of breath or difficulty breathing, fatigue, headache, sore throat, nasal congestion or runny nose, nausea or vomiting, diarrhea, or new loss of taste and/or smell in the past 10 days?
Please answer “yes” only if you are experiencing a new onset of symptoms OR you are experiencing a change in symptoms from your baseline if you have a known pre- existing medical condition (e.g. asthma, allergies).
2. Is your temperature 100 degrees Fahrenheit or greater today?
3. Have you tested positive for COVID-19 in the past 10 days?
4. Have you had contact with anyone confirmed or suspected of having COVID-19 in the past 10 days?
Do any of the statements listed above apply to you and/or your student?
Yes one or more of the COVID statements apply to us. (Please contact your school nurse)
No, the COVID statements do not apply to us.
Attendance - please read complete statements before selecting.
My student will be ABSENT and not participate in classwork today.
My student will be PRESENT and in the school building today.
A copy of your responses will be emailed to the address you provided.
Never submit passwords through Google Forms.
This form was created inside of Eden Central School District.