Student Daily Wellness Screening Form

This form must be completed by parents/guardians for each day that their child comes to school.

If the child is experiencing symptoms of COVID-19 and/or has been exposed to anyone with COVID-19, YOU MUST KEEP THE CHILD AT HOME and call the school office.

People have reported a wide range of COVID-19 symptoms ranging from mild symptoms to severe illness.

Symptoms may appear 2-14 days after exposure to the virus. These symptoms could include

• fever or chills,
• cough,
• headache,
• sore throat,
• shortness of breath or difficulty breathing,
• loss of taste or smell,
• muscle pain,
• congestion or runny nose,
• rash,
• conjunctivitis or pink eye,
• nausea or vomiting,
• diarrhea,
• abdominal pain or stomach ache,
• fatigue.

YOU MUST KEEP YOUR CHILD AT HOME, if any of the checkboxes listed above applicable to your child.