Question Title

* 1. Please enter your first and last name (person completing this survey).  This will serve as your signature that all information is correct.

Question Title

* 2. Please enter the name and grade of each of your children attending WCS

Question Title

* 3. Is anyone living in your home currently experiencing new or worsening symptoms, such as fever, sore throat, cough, loss of taste or smell, shortness of breath, etc.?

Question Title

* 4. If yes, please explain.

Question Title

* 5. In the past 10 days, has your child who attends WCS been in contact with a person who has been diagnosed with COVID-19 or developed symptoms of COVID-19?

Question Title

* 6. Has everyone living in your home complied with New York State's travel advisory? - please visit the following link: https://coronavirus.health.ny.gov/covid-19-travel-advisory.

Question Title

* 7. If no, please explain.

Question Title

* 8. Date you completed this survey

Date
0 of 8 answered
 

T