STUDENT/PARENT DAILY CHECK-IN

PLEASE COMPLETE THE FORM BELOW EACH MORNING PRIOR TO DROPPING OF YOUR CHILD.

STUDENT DAILY CHECK-IN

* Indicates required field

Name of Child *

First

Last

GRADE LEVEL *

DID YOUR CHILD REGISTER A TEMPERATURE OF 100 DEGREES OR HIGHER THIS MORNING? *

YES NO

HAVE YOU OR ANYONE IN YOUR HOUSEHOLD BEEN IN CONTACT WITH SOMEONE THAT TESTED POSTITIVE FOR COVID-19 WITHIN THE PAST 14 DAYS? *

YES NO

DOES YOUR CHILD HAVE ANY OF THE SYMPTOMS LISTED ON THE PARENT/STUDENT CHECKLIST? *

YES NO

DID YOU ANSWER YES TO ANY OF THE PREVIOUS QUESTIONS? IF YOU ANSWERED YES, YOUR CHILD MUST REMAIN HOME AND THE SCHOOL CONTACTED. *

YES NO

Submit

Remember, COVID-19 affects different people in different ways. Infected people have had a wide range of symptoms reported - from mild symptoms to severe illnesses.

PLEASE COMPLETE THE DAILY CHECK-IN FORM PRIOR TO 6:30 AM & BEFORE DROPPING YOUR CHILD OFF EACH MORNING TO HELP ENSURE READY CAN PROVIDE A SAFE AND ORDERLY DROP-OFF FOR YOUR CHILD.

PARENT/STUDENT CHECKLIST
PRIOR TO LEAVING HOME
Check for the following COVID-19 Symptoms

Fever / Chills
Cough / Sneezing
New Loss of Taste / Smell
Shortness of Breath
Rash / Nausea / Vomiting / Diarrhea (Signs of other illnesses)
Temperature of 100.4 Degrees and Over

My Child Has a Symptom - What Should I Do?

Stay Home
Notify the School
If Anyone in the Household is Sick - Please Keep All Children at Home
Get Medical Attention if Needed

STUDENT DAILY CHECK-IN

SCHOOL INFORMATION