COVID-19 Student Daily Screening Form


    Parents are required to complete the above Symptom Screening Form for their child prior to arriving to school each day to determine whether or not they should attend. 


    COVID-19 is a new illness that can affect your lungs and airways. It is caused by a virus called coronavirus (also known as COVID-19 or SARS-CoV-2).

    SECTION 1: Symptoms

    If your child has any of the following symptoms that indicate a possible illness that may decrease your child’s ability to learn and also put your child at risk of spreading illness to others, or say “no” to any of the following questions, your child is not cleared to report to school. Be advised that a school official will contact you.


    • Temperature 100.4 degrees Fahrenheit or higher when taken by mouth
    • Sore throat
    • New uncontrolled cough that causes difficulty breathing (for students with chronic allergic/asthmatic cough, a change in their cough from baseline)
    • Diarrhea, vomiting, or abdominal pain
    • New onset of severe headache, especially with a fever


    SECTION 2: Close Contact/Potential Exposure

    Have you had close contact or potentially been exposed to an infected person according to the conditions set forth below?


    • Had close contact (within 6 feet of an infected person for at least 15 minutes) with a person with confirmed COVID-19
    • Traveled to or lived in an area where the local, Tribal, territorial, or state health department is reporting large numbers of COVID-19 cases as described in the Community Mitigation Framework (www.krsd.org/Mitigation)
    • Live in areas of high community transmission (as described in the Community Mitigation Framework) while the school remains open