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COVID-19 Self Screen

Last Updated: 8/10/2021 9:34 PM

Parents: if you answer yes to any of these questions for your child, please keep your child home. Please contact your school to inform them of the situation.

Staff: If you answer yes to any of these questions, you must stay home. Please contact your supervisor.

To download and view a PDF, click here.

Para descargar y ver un PDF, haga clic aquí.

 

COVID-19 Screening Questions    

Has your child or staff person experienced any of the following symptoms in the past 48 hours:

 

  • fever or chills
  • cough
  • shortness of breath or difficulty breathing
  • fatigue
  • muscle or body aches
  • headache
  • new loss of taste or smell
  • sore throat
  • congestion or runny nose
  • nausea or vomiting
  • diarrhea
Yes No

Does your child or staff person have a temperature of 100.4 degrees Fahrenheit or higher?

Yes No

Is your child or staff person isolating or quarantining because they tested positive for COVID-19 or are worried that you may be sick with COVID-19?

Yes No

Is your child or staff person fully vaccinated?* OR Have they recovered from a documented COVID-19 infection in the last 3 months?

*To be considered fully vaccinated, you must be ≥2 weeks following receipt of the second dose in a 2-dose series or ≥2 weeks following receipt of one dose of a single-dose vaccine.

Yes No

Has your child or staff person been in close physical contact* in the last 14 days with:

anyone who is known to have laboratory-confirmed COVID-19?

OR

anyone who has any symptoms consistent with COVID-19?

*Close physical contact is defined as being within 6 feet of an infected/symptomatic person for a cumulative total of 15 minutes or more over a 24-hour period starting from 48 hours before illness onset (or, for asymptomatic individuals, 48 hours prior to test specimen collection).

Yes No

Is your child or staff person currently waiting on the results of a COVID-19 test?

IMPORTANT: ANSWER “NO” IF YOU ARE WAITING ON THE RESULTS OF A PRE-TRAVEL OR POST-TRAVEL COVID-19 TEST

Yes No

Has your child or staff person traveled* in the past 10 days?

*Travel is defined as any trip that is overnight AND on public transportation (plane, train, bus, Uber, Lyft, cab, etc.) OR any trip that is overnight AND with people who are not in your household.

Yes No