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.