COVID-19 Daily Questionnaire



Please complete the questionnaire daily, before bringing your child to school

Your Child's Name:

Your E-mail:

Has your child (children) had any of the following symptoms within the past 72 hours:

Temperature/fever of 100.4* F or above?

NOYES

Cough? NOYES

Shortness of breath? NOYES

Close contact with anyone exhibiting any of the above symptoms? NOYES

If you answered YES to any of the above questions, your child must be symptom-free for a minimum of 72 hours, and return with a Dr's note. We appreciate your cooperation in ensuring the health of our kids.