Please complete this form each school

day after 06:00 am.

Have you or ANY student in your household experienced any of the following symptoms in the previous 14 days:

  • Fever >100.3ChillsCough,  or Sore Throat

  • Shortness of Breath or Difficulty Breathing

  • Decreased Ability to Taste or Smell

  • Runny or Congested Nose

  • Muscle or Body Aches or Fatigue

  • Headache

  • DiarrheaNauseaVomiting 


  • Been in close contact with someone diagnosed with COVID-19


If you will not be participating in on-campus instruction due to prior symptoms/exposure please also select YES.