Health Questionnaire Regarding Covid-19

Updated Fall 2021
Following CDC recommendations, we ask that students and families continue to practice daily health screenings, physical distancing, handwashing and respiratory etiquette, and maintaining our clean environment by disinfecting personal areas. Students are to complete the questionnaire daily before attending class.

Guilford County is currently requiring masks for all individuals in public facilities and businesses. We will work individually with our groups and families to determine the best course concerning masking during physical activity in order to keep everyone safe. As students are able to maintain physical distancing, and spreadout in the larger spaces and/or outdoor spaces, we may determine that masks are optional for groups and/or individuals. We will communicate any shifts of policy before a change is made concerning your student.

Please answer the following questions below:

* Student First Name

* Student Last Name

* Are you unwell with one high or two low Covid-19 symptoms as listed below?

High Risk Symptoms for COVID-19 include:

Shortness of breath/labored breathing
Loss of sense of taste or smell
New or worsening cough (a change from baseline)

Low Risk Symptoms for COVID-19 include:

Nausea, vomiting, or diarrhea
New onset of severe headaches
Sore throat
Fever/Chills
Fatique
Nasal congestion/drainage (change from baseline)
Muscle aches

* Are you, a family member, or someone you are in close contact with positive for COVID-19, currently awaiting test results, or experiencing COVID-like symptoms?

* Have you had a fever (temperature >100F) or chills in the past 24 hours? (Please call GPA office before returning if you have been fever free without medication for 72 hours.)

Health Questionnaire Regarding Covid-19

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