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Covid - 19 Check In

COVID-19 Check In 

1.In the last 14 days, have you received a confirmed diagnosis for coronavirus ( COVID-19) by a coronavirus ( COVID -19) test or from a diagnosis by a health care professional or are you waiting for a pending COVID-19 test result?(Required.)
2.In the last 14 days, have you had close contact with or cared for someone currently diagnosed with COVID-19 ?(Required.)
3.In the last 14 days, have any one in your family experienced any cold or flu symptoms ( to include fever,cough, shortness of breath or difficulty breathing, sore throat, pressure in the chest, diarrhea, vomiting, muscle pain, loss of smell or taste)?(Required.)
4.Does your child have any of the following symptoms running nose, cough, fever, or diarrhea?(Required.)
5.I understand that if my child experience any of the following symptoms at the Learning Center today running nose, fever, diarrhea, continuous cough, I must pick up my child within 45 minutes(Required.)
6.What is your child’s name?(Required.)
7.What is your first name and last name (Required.)
8.I am a 
9.ENTER DATE/ TIME
TIME 
Time
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