School Covid Testing

School Covid-19 Testing

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Name and Surname of your child?

Are you sending your child to school today?

YesNo

Class

3-12 months (2019)1-2 years (2018)2-3 years (2017)3-4 years (2016)4-5 years (2015)Grade R (2014)

Does your child have a high fever?

YesNo

Ok to Enter

Access to school approved. OK to enter.

DO NOT ENTER

DO NOT ENTER

Does your child have a cough?

YesNo

Does your child have redness in eyes?

YesNo

Does your child have shortness of breath?

YesNo

Does your child have a sore throat?

YesNo

Does your child have body aches?

YesNo

Did your child travel outside of SA in the last 14 days?

YesNo

Within the last 14 days, did your child have direct contact with someone known to have contracted the Coronavirus disease (COVID-19)?

YesNo

Does your child have a loss of smell of taste?

YesNo

Does your child have diarrhea?

YesNo

Is your child nauseas?

YesNo

Does your child feel fatigue? (Weakness or tiredness

YesNo

Date

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