• Health Screening Questionnaire

    Thank you for taking the time to answer these questions. The following questions are to inform our staff team about your child(ren)'s health today. If you have more than one child registered for program, you can now include multiple children's names on this form. Please note that the date and time is automatically recorded when completing this questionnaire.
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  • 1. Do you, your child(ren), or any member of your household have any of the following symptoms:

  • Thank you for your responses. This form will be submitted to our Health Screening Staff at the {whereIs}.

    They will be taking your child(ren)'s temperature with an infrared (contactless) thermometer upon entry, and recording the temperature on this Health Questionnaire.

    Thank you very much for your patience and understanding!

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