Daily Health Screening Questionnaire Please complete the screening questionnaire prior to entry into the building. School admittance times for students is as follows. Freshman & Sophomores – 8:15 – 8:30am Juniors & Seniors – 8:25 – 8:40am. Covid Daily Screening Form Student Name* First Last Email* Do you have or have you had over the past 3 days a Temperature of 100.4 degrees Fahrenheit or higher and or chills?* Yes No Do you have or have you had over the past 3 days a sore throat ?* Yes No Do you have or have you had over the past 3 days a new uncontrolled cough causing difficulty breathing?* Yes No For students with chronic allergic/asthmatic cough, a change in their cough from baseline.Do you have or have you had over the past 3 days shortness of breath or difficulty breathing?* Yes No Do you have or have you had over the past 3 days unusual fatigue?* Yes No Do you have or have you had over the past 3 days any muscle or body aches?* Yes No Do you have or have you had over the past 3 days Diarrhea, vomiting, or abdominal pain?* Yes No Do you have or have you had over the past 3 days a new onset of severe headache, especially with a fever?* Yes No Do you have or have you had over the past 3 days a recent loss of taste or smell?* Yes No Have you Had close contact (within 6 feet for at least 15 minutes) with someone who has confirmed COVID-19 in the past 14 days?* Yes No Have you had a positive COVID-19 test for active virus in the past 10 days? Yes No Within the past 14 days, has a public health or medical professional told you to self-monitor, self-isolate, or self-quarantine because of concerns about COVID-19 infection?* Yes No Have you traveled outside the state in the last 14 days?* Yes No If you answered yes to any of the above questions, please remain at home. Please have a parent/guardian call the school office and let us know.
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