Daily Health Survey

Every evening before the school day, parents need to "attest" to their child's health by completing the Daily Symptom Check survey. Staff will also need to attest to their own health.

- A daily email will be sent to families & staff with a link to the survey.
- Please submit the Daily Symptom Check survey for the next school day by midnight.
- Double check for health changes each morning.
- Students who do not have a health survey submitted will undergo health screening upon arrival.
- If a student or staff member is diagnosed with COVID-19, their family should notify the school immediately.

To attest to health, parents (and staff) will need to answer these questions:

Q1: This is a daily symptom check. Based on your responses, you will either be certified to participate and come to school, or you will be directed to other health resources.

By completing the survey and submitting your responses, you agree that the information collected can be used by [School] to provide a safe environment for you and your fellow classmates, faculty and staff. The data will be used solely to determine if you should be on campus at this time and will be confidential.

- Yes, I consent
- No, I decline

Q2: In the past week, have you . . . (Check all that apply)

- Been ill
- Recently cared for someone who is/was ill
- Traveled from a community with a significant number of COVID-19 cases (e.g. California)
- Been in contact with someone who has tested positive for COVID-19
- Been contacted by someone about your possible exposure to COVID-19
- None of the above

Q3: Do you currently have any of the following sever symptoms? . . . (Check all that apply)

- Extreme shortness of breath
- Blue lips or face
- Chest pain or discomfort
- Severe dizziness or lightheadedness
- None of the above

Q4: Do you currently have any of the following symptoms? . . . (Check all that apply)

- Fever (temperature greater than 100.3 F)
- Chills (uncontrollable body shaking)
- Cough that is new or worsening
- Recent decrease in sense of smell or taste
- None of the above

Q5: (Answer only if "yes" to Q4.) Have you been tested for COVID-19 in the past seven days?

- Yes
- No

Q6: Do you currently have any of these symptoms? . . . (Check all that apply)

- Fever (temperature greater than 100.3 F)
- Chills (uncontrollable body shaking)
- Cough that is new or worsening
- Recent decrease in sense of smell or taste
- None of the above

These are visible symptoms parents and staff should look for:

- Fever (above 100.3) 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