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Student Health Screening Questionnaire

Family I D Health Screening Questionnaire
December 2021 Health Screening Questionnaire: Please complete for 

each child attending 
school in person by 7 a.m. on Wednesday, December 1:


Family I D Health Screening Questionnaire
November 2021 Health Screening Questionnaire: Please complete for 

each child attending 
school in person by 7 a.m. on Monday, November 1:


For more information on the FamilyID sign-up process, click here.

PLEASE NOTE: The information below is subject to change based on local, state and federal guidance/information.

More information:

Daily Health Screening
Parents/guardians must complete a daily health screening of their child(ren) prior to having them report to in-person instruction. While these won’t be manually submitted on a daily basis, it is extremely important to complete the screening each day with fidelity. Please do not send your child to school if they do not meet the health screening criteria.

Students/parents/guardians are required to notify the school nurse's office when they develop symptoms or if their health screening answers change during or outside school hours.

Screening by the parent/guardian prior to school each day is required, including daily temperature checks and symptom screening being performed before entering school/boarding the bus. Parents/Guardians will need to complete the FamilyID Health Screening Questionnaire for each child by the 1st of every month. Please see "Monthly FamilyID Student Health Screening Questionnaire" information below for further details.

A health screening determines:
  • Has your child knowingly been in close or proximate contact in the past 10 days with anyone who has tested positive through diagnostic test for COVID-19 or who has or had symptoms of COVID-19?
  • Has your child tested positive through a diagnostic test for COVID-19 in the past 14 days?
  • Has your child experienced any new or worsening symptoms of COVID-19, including dry cough, shortness of breath, new loss of sense of smell or taste, nausea, vomiting, diarrhea, or extreme tiredness?
  • Has your child experienced a temperature of greater than 100.0 degrees Fahrenheit in the past 14 days?
As in previous years, please make sure that the attendance office is also aware of any absences of your child.

Monthly FamilyID Student Health Screening Questionnaire

  • This online health screening questionnaire via FamilyID serves as a confirmation that you are completing the daily at-home health screening of your child with fidelity. The online FamilyID questionnaire needs to be completed monthly.
  • Within five (5) days of the 1st of EVERY month, you must complete and submit the online FamilyID health screening questionnaire for each child. You will receive an email link from the district each time prompting you to submit the questionnaire. There will be a new link sent before the 1st of each month. Each up-to-date link will also be available through our district website.

If you have any questions regarding the questionnaire, please reach out to Mr. Brad Tomm (Director of Athletics, Physical Education and Health, and Assistant Principal 7-12) at (607) 762-6904 or [email protected] for assistance.