Brave Arts Medcheck form
Please complete this health screening form for each child you are dropping off at Brave Arts Monday-Friday. If you answer YES to any of the symptom questions below please keep your child home. If your child will NOT be attending Brave Arts due to other illness, COVID symptoms or exposure please contact Sarah at 508-314-1792 prior to 9:00 AM.
Child's First and Last Name
Is your Brave Arts participant experiencing any of the following symptoms:
Fever (above 100 degrees)
Cough (unrelated to seasonal allergies)
Runny nose (unrelated to seasonal allergies)
Shortness of breath
Sore throat (unrelated to seasonal allergies or vocal fatigue)
Unusual or unexplained headache
Unusual or unexplained fatigue
Chills or body aches
Vomiting or diarrhea
Loss of smell or taste
None of the above
In the last 14 days has your child been in close contact with anyone diagnosed with COVID-19 OR (if unvaccinated) been placed on quarantine for possible contact with COVID-19?
In the past 14 days, has your child been asked to self-isolate or quarantine by a medical professional or public health official?
If your child is experiencing any of the listed symptoms or has been notified to isolate or quarantine due to confirmed exposure please do not come to Brave Arts and call Sarah to discuss at 508-314-1792 as soon as possible.
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