Sample #1 Daily Health Check

You MUST Submit before leaving this form or ALL entries will be lost.
Arrival group *
The CDC has identified the following COVID-19 symptoms
● Fever over 100.4°F
● 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
 
Before bringing your child to our center, take your child's temperature and screen your child for COVID-19 symptoms. For the health and safety of children, staff, and parents, if your child exhibits any of these symptoms, or any other symptoms of illness, do not bring your child to the center.
Check below to confirm your child does not exhibit any sympoms of illness.
Confirmation *