• Student and Staff COVID-19 Daily Self Checklist

    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

    THIS FORM IS FOR AT-HOME USE AND DOES NOT NEED TO BE SUBMITTED TO THE SCHOOL.

    Download the checklist by clicking here!