Covid-19 Health Screening

FORM IS NOW CLOSED

IT WILL RE-OPEN TOMORROW AT 5AM.

Form is open from 5am-12pm daily, please have your results screen or email ready to show facutly/staff upon arrival.
Covid-19 Health Screening

Please fill out one screening per student daily
Student Name*

First Name Last Name
Date*

MonthDay Year
Date
Parent Email*
example@example.com
Is your child experiencing any Covid/Cold/Flu Symptoms?*

YesNo
Was your child's temperature greater than 100.4°F?*

YesNo
Have you administered fever reducing medication to your child?*

YesNo
Have you travelled out of country within the past 10 days?*

YesNo
Have you/your child been exposed to anyone with COVID?*

YesNo
Time

:Hour Minutes AM/PM Option
Should be Empty: