Copy of COVID-19 SCREENING CHECKLIST

Name and Surname of your child

Are you sending your child to school today?

Class

Does your child have any symptoms? (Cough, Redness in eyes, short breath, sore throat or body aches)

Did your child travel outside of SA in the last 10 days?

Within the last 10 days, did your child have direct contact with someone known to have contracted the Coronavirus disease (COVID-19)?

Does your child have a high fever?

Date

YOU MAY ENTER

DO NOT ENTER