COVID-19 Daily Screen

* Indicates required field

Child's Name *

Date *

Does your child or anyone in your household have any of the following:

Fever *

Cough *

Difficulty Breathing *

Sore Throat, Difficulty Swallowing *

Sore Throat or Red Eyes *

Loss of Taste or Smell *

Not Feeling Well, Tired or Sore Muscles *

Nausea, Vomiting, Diarrhea *

Have you been in close contact with anyone who is sick or has confirmed COVID-19 in the past 14 days? *

Have you returned from travel outside Canada in the past 14 days? *

Further Explanation of any "Yes" responses *

* By submitting below you are acknowledging that the above information is correct and accurate.

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