Health Screening Form

  • Avalon Children's Montessori School COVID Screening Questions


    Students and children must screen for COVID-19 every day before going to school or child care. Parents/guardians can fill this out on behalf of a child.

    Please note you must do one submission for each Avalon Children's Montessori School student in your family.

    Scroll down to see the chart with the new isolation guidelines based on vaccination status.

  • Please take your child’s temperature and record the results here

  • 1. A) Does the child/student or anyone in the household has one of these new or worsening symptoms?


    If the symptom is from a known health condition that gives them the symptom, select “No”. If the symptom is new, different or getting worse, select “Yes”.

    If there is mild tiredness, sore muscles or joints within 48 hours after a COVID-19 vaccine, select “No”. If longer than 48 hours, select “Yes.”

    Anyone who is sick or has any symptoms of illness, should stay home and seek assessment from their health care provider if needed.

  • Temperature of 37.8 degrees Celsius/100 degrees Fahrenheit or higher and/or chills

  • B) Does the child/student or anyone in the household has any of these new or worsening symptoms?


    *Symptoms include 1 or more symptoms from 1.A or 2 or more symptoms from 1.B on the screening tool

    If the student/child has one symptom from 1.B, other household members do not have to self-isolate.

    In the context of Omicron, individuals who are previously positive in the last 90 days and not fully vaccinated are not considered equivalent to fully vaccinated.

  • If “YES”: Stay home & self-isolate.

  • If the student/child is fully vaccinated**, or public health has told you that you do not need to self-isolate, select “No.”

    If “YES”: Stay home & self-isolate.

  • If “YES”: Follow federal quarantine travel rules.

  • Date Format: MM slash DD slash YYYY