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Daily Wellness Check
Daily Wellness Check
This form must be filled out on days you plan on attending any activities at Gateway.
Any student with positive symptoms will not be allowed to return to school or take part in workouts. Students with positive symptoms must obtain medical clearance from his or her primary care provider or other appropriate healthcare professional prior to returning to campus.
Please select yes if you are experiencing any of the following symptoms. This form must be submitted each day by 7:30 AM.
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* Indicates required question
Please Select Department or Reason for entering the the school.
*
Choose
Cafeteria
Maintenance
Transportation
Visitor
Faculty or Office Staff
Enter your Name
Your answer
Do you have fever >100.4?
*
Yes
No
Do you have shortness of breath?
*
Yes
No
Do you have sore throat?
*
Yes
No
Do you have chills?
*
Yes
No
Do you have muscle aches or rigors?
*
Yes
No
Do you have headaches?
*
Yes
No
Do you have a new loss of taste or smell?
*
Yes
No
Have you experienced stomach pain, nausea, vomiting, and/or diarrhea?
*
Yes
No
Have you been in contact with someone that is currently sick and/or has tested positive for COVID-19?
*
Yes
No
If you took your temperature this morning, what was the reading?
*
Your answer
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