By completing this form and receiving a green checkmark, you agree that you will not enter the building until this form has been reviewed by a designated screener who will complete the rest of the Daily Health Screening requirements.

SYMPTOMS: Are you experiencing any of the following covid-19 related symptoms?

• fever (100.4 degrees Fahrenheit or higher),
• chills,
• cough,
• shortness of breath or difficulty breathing,
• fatigue,
  muscle or body aches,
• headache,
• new loss of taste or smell,
• sore throat,
• congestion,
• nausea or vomiting,
• diarrhea, or
• otherwise feeling unwell.

TEST RESULTS: Have you taken a COVID-19 test and are waiting for test results?

EXPOSURE: Have you been in close contact with a person who has COVID-19? (This could be a friend, family member, household member, etc.)

Pick up an exit ticket and leave the building. You cannot enter the building today. You have answered "Yes" to the SYMPTOMS, TEST RESULT or EXPOSURE question. You should go home, isolate immediately and call your healthcare provider. The school will contact you soon. Thank you for your cooperation.

If allowed into the building:

• you agree to follow all applicable guidelines for campus visits in order to protect the safety and health of you and the rest of the school community.
• you acknowledge you have taken your temperature no more than 2 hours in advance of requesting entry into the school building.
• if you have not taken your temperature or it has been more than 2 hours, you will allow the School representative to take your temperature when you arrive at the building.