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Daily Health Attestation
This form must be filled out EVERY DAY that your child attends

Has the child or anybody in your household exhibited the symptoms below in the past 24 hours?

Fever (100F or higher) or had chills?
Cough?
Sore Throat?
Difficulty Breathing?
Nausea, vomiting or diarrhea?
Loss of Taste or Smell?
Muscle Aches?

If your child has the following symptoms not in combination with any of the above, they are approved to attend.

  • Fatigue

  • Head Ache

  • Runny Nose or Congestion

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Has the child or another houshold member had close contact with a Covid-19 Positive individual in the past 14 days?

Thanks for submitting!

If you answered yes to any of the above questions your child may not attend today. Please contact me for more information.

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