COVID-19 Pre-Screening Health Questionnaire
LP21 is asking all students and visitors to complete a pre-screening check to mitigate the risk to our staff and students. It is imperative that you complete this form as accurately as possible prior to entering the center.
If you have had any of the following symptoms within the past 48 hours staff and students should remain at home.
Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea
Staff and students should remain at home if any of the following statements are true.
Tested positive for COVID-19 in the past 10 days
Currently awaiting results from a COVID-19 test
Have been diagnosed with COVID-19 by a licensed healthcare provider (for example, a doctor, nurse, pharmacist, or other) in the past 10 days
Have been told that you are suspected to have COVID-19 by a licensed healthcare provider in the past 10 days
If at any time, my or my family’s symptoms or exposure changes, and we answer yes to any of the previous statements, I will notify LP21 immediately by email at programs@lp21.org
