Please read the MPS Health Pre-Screening Checklist found here before completing this form. All MPS families must commit to performing the MPS Health Pre-Screen Checklist on a daily basis. 

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* 1. Enter your child's last name here: 
If you have more than one child in MPS, please take this survey again for each child. 

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* 2. Enter your child's first name here: 

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* 3. Please choose from below:

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* 4. What school does your child attend?

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* 5. I have read the MPS Daily Pre-screening Checklist and I agree to perform this prescreen every day. Please enter your name below. 

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