Daily COVID-19 Health Screening
Please complete this form before arriving to each day of class/camp. This form must be completed each day by all students, staff, YLP members, and anyone else entering the building for class every day. Please do not come to DMR if you have any COVID-19 symptoms, even if you are vaccinated. If you have symptoms from the list but which arise from other issues according to your doctor, please send us a doctor's note.
If answer to any of the following questions is YES, you must stay home.
Please do not fill this out in advance of the day you attend
What is the nature of your visit?
Are you experiencing any of the following symptoms?
Fever/chills with a temperature of 100.4˚F or above
Shortness of breath or difficulty breathing
Muscle or body aches
Loss of taste or smell
Congestion or runny nose
Nausea or vomiting and/or diarrhea
If you are not fully vaccinated, have you been in close contact with an individual who has tested positive for COVID-19 within the past 14 days?
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If this error persists, please ask a staff member for a physical copy of this form.