Muppets Children's Centres

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Does your child have any of the following NEW or WORSENING symptoms: fever, cough, difficulty breathing, loss of taste or smell, nausea, vomiting, diarrhea? Has your child been given fever reducing medication in the last 24 hours? *

Yes No

Child(ren) Name(s) *

Does anyone in your child's household have one or more of the symptoms listed above/or waiting for test results after experiencing symptoms? *

Yes No

In the last 10 days, has the child tested positive on a rapid antigen test or a home-based testing kit? Has your child/student been notified as a close contact of someone with COVID 19 or been told to stay home and self isolate? *

Yes No

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

In the last 14 days, has your child travelled outside of Canada and been advised to quarantine per quarantine requirements? *

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