COVID-19 Screening Form
All employees in SHSD have student, staff and community safety as their primary concern. Our collective work as a community to prevent the virus from spreading will allow our district and schools to continue our operations. If we all take responsibility for following a few rules, our chances of preventing and containing the virus improve dramatically.
STAY HOME WHEN YOU ARE SICK OR IF YOU'VE HAD CLOSE CONTACT WITH SOMEONE WHO HAS COVID-19
WEAR A MASK AND MAINTAIN PHYSICAL DISTANCING OF 6 FEET
WASH YOUR HANDS FREQUENTLY
On the days you will be in-person at your work site, you must complete and submit this form PRIOR to leaving your home.
Have you had any of the following symptoms in the last 72 hours that are not attributable to another condition?
Fever of 100.4 F or higher or a sense of having a fever
Cough, shortness of breath or difficulty breathing
New loss of taste or smell
Persistent muscle aches or pains
Congestion/running nose - not related to seasonal allergies
Nausea, vomiting, or diarrhea
I have not had any symptoms
Does anyone in your household have any of the above symptoms that are not attributable to another condition?
Have you or anyone in your household been in close contact with anyone with suspected or confirmed COVID-19 in the past 14 days?
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This form was created inside of STEILACOOM HISTORICAL SCHOOL DIST.