Student Health Screening
Your child must complete a health screening each day before they attend school or visit a school campus in person. Please check your child's temperature, complete the form below, and if you answer yes to any of the questions, keep your child home from school and notify the health room at your school. Please bookmark this site for easy access for the foreseeable future.
Email address *
Parent/Guardian First and Last Name *
Student First and Last Name: *
Parent/Guardian Email Address *
Student Email Address (if applicable)
School Name *
Do you or have you had any of the symptoms listed below during the last 14 days? *
Symptoms
* A new fever (100.4 degrees or higher), or a sense of having a fever.
* A new cough that you cannot attribute to another health condition.
* New shortness of breath that you cannot attribute to another health condition.
* A new sore throat that you cannot attribute to another health condition.
* New muscle aches that you cannot attribute to another health condition, or that may have been caused by a specific activity (such as physical exercise).
* Headache that you cannot attribute to another health condition.
* Fatigue that you cannot attribute to another health condition.
* New loss of taste or smell that you cannot attribute to another health condition.
* Congestion or runny nose that you cannot attribute to another health condition.
* Nausea or vomiting that you cannot attribute to another health condition.
* Diarrhea that you cannot attribute to another health condition.
Have you had any of the above symptoms in the past three days? *
Have you been in close contact (within 6' for more than 15-minutes) with anyone with suspected or confirmed COVID-19? *
Have you had a positive COVID-19 test for active virus in the past ten days? *
Within the past 14 days, has a public health or medical professional told you to self-monitor, self-isolate, or self-quarantine because of concerns about COVID-19 infection? *
Attestation
If the answer to any of the above is yes, you may not enter school or district facilities.
I certify that the answers herein are true and correct. *
A copy of your responses will be emailed to the address you provided.
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