COVID-19 Self-Screening Form
This form lets you tell us that you are not safe to be at campus based on a self-screening at home, and helps us understand why you cannot attend so that we take the appropriate steps to keep everyone safe and support you.
Email address *
Student Name / Nombre del estudiante *
Best contact information for follow up. / La mejor información de contacto para seguimiento. *
In the self-screening at home I answered YES to these questions, and so I can NOT safely come to campus for school. / En la autoevaluación en casa, respondí SÍ a estas preguntas, por lo que NO puedo ir a la escuela de manera segura. *
Captionless Image
Do you plan to, or have you already had a COVID-19 test? *
Never submit passwords through Google Forms.
This form was created inside of Armadillo Technical Institute. Report Abuse