Loudoun County Public Schools COVID-19 Prevention Daily Questionnaire for Students
Parents, please answer these questions for your child each day, prior to their departure for school. Answer “YES” or “NO” has your child had any of the following:
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Student Name (Last, First) *
Date *
MM
/
DD
/
YYYY
1. A new fever (100.4°F or higher) or a sense of having a fever? *
2. Medication to reduce fever in the last 24 hours? *
3. A new cough that you cannot attribute to another health condition? *
4. New shortness of breath that you cannot attribute to another health condition? *
5. A new sore throat that you cannot attribute to another health condition? *
6. New muscle aches (myalgia) that you cannot attribute to another health condition, or that may have been caused by a specific activity (such as physical exercise)? *
7. New onset of loss of sense of taste or smell? *
8. Nausea or Vomiting? *
9. Diarrhea? *
10. A new onset of congestion or runny nose that you cannot attribute to another health condition? *
11. Has your child been around some one who is sick in the last 48 hours? *
12. Has your child been around someone who has tested positive for COVID-19 in the last 48 hours? *
If you answered “YES” to any of the questions above:· DO NOT send your child to school.·
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