Fort Lewis Mesa Elementary COVID-19 Student Online Health Screening Form

Each student must be screened for symptoms prior to boarding the bus or arriving at school. A Health Screening Form must be completed daily. A separate form must be completed for each student. IF THE STUDENT REPORTS ANY OF THE FOLLOWING SYMPTOMS, KEEP THE STUDENT HOME AND CALL THE SCHOOL'S ATTENDANCE LINE TO REPORT THE STUDENT'S ABSENCE: Cough, fever of 100.4 or more, runny nose, nausea/vomiting, diarrhea, headache, chills, muscle aches, sore throat or new loss of taste or smell Durango School District 9-R must retain these forms in a secure place for three months, and provide the forms upon request from public health agencies.

Fort Lewis Mesa Elementary
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Does your student have ANY of the following symptoms: cough, fever, runny nose, nausea/vomiting, diarrhea, headache, chills, muscle aches, sore throat or new loss of taste or smell?*

If the student has any symptoms, KEEP THE STUDENT HOME. CALL THE SCHOOL'S ATTENDANCE LINE TO REPORT THE STUDENT'S ABSENCE.

Have you been made aware that you were in close contact with somebody who tested positive for COVID-19?*
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