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Daily Student Health Questionnaire
Posted 4/1/21

Panther Families,

Please complete this passive screening at home before students come to school. You do not need to bring in a physical copy to turn in. Thank you! 

 

Daily COVID-19 Student Health Screening Questionnaire

 

In the past 24hrs, has your child experienced?

 

Fever/Temp of 100.4 or higher?

Yes 

No

Fatigue

Yes

No

Frequent Dry Cough

Yes

No

Aches/Pains

Yes

No

Sore Throat

Yes

No

Diarrhea

Yes

No

Headaches

Yes

No

Shortness of Breath

Yes

No

Loss of Smell or Taste

Yes

No

Have you recently been in contact with anyone who has exhibited any of these symptoms? Or been exposed to anyone diagnosed with Covid-19. 

Yes

No