Complete this check each morning before you/your child leaves for school.

If you CHECK any item below, your child/you must STAY HOME, and you must notify your child’s school nurse and principal.

Please check your child/yourself for these symptoms:

• Fever of 100.4 degrees or higher
• Chills or feeling feverish
• New, uncontrolled cough that causes difficulty breathing
• Shortness of breath or difficulty breathing
• Loss of sense taste or smell
• Sore Throat
• Significant fatigue, muscle or body aches
• New onset of severe headache, especially with fever
• Diarrhea, nausea, vomiting, abdominal pain

If your child/you have any of these symptoms, they/you may have an illness that puts them/you at risk for spreading illness to others. For a full list of COVID-19 symptoms, click here: https:\\www.cdc.gov\coronavirus\2019-ncov\symptoms-testing/symptoms.html

Have your child/you had close contact (within 6 feet of an infected person for at least 15 minutes) with a person with confirmed COVID-19 in the last 14 days?

• Yes
• No

Do you have a household member who has tested positive for COVID-19 or has had symptoms of COVID-19 in the last 14 days?

• Yes
• No

Have you traveled to any Affected States identified in the State of Connecticut’s Travel Advisory https://portal.ct.gov/coronavirus/travel in the past 14 days?

• Yes
• No