Muppets Children's Centres

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Does your child have any of the following symptoms: fever, cough, difficulty breathing, sore throat, trouble or pain swallowing, stuffy or runny nose, headache, loss of taste or smell, sore muscles, extreme tiredness, nausea, vomiting, diarrhea? *

Yes No

Child(ren) Name(s) *

Has your child been in close contact with someone who has confirmed COVID-19 in the past 14 days or has anyone in the household travelled outside of Canada? *

Yes No

Has your child been given fever reducing medication in the last 24 hours? *

Yes No

Please note: Our educators will perform a temperature check upon arrival from school.

Is there a sibling or other member in your household who has one or more of the symptoms listed above? *

Yes No

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Welcome to Muppets Children's Centre's Daily Screening Survey

Thank you for taking the time to complete the survey