The health screening forms are available to download and print. We will collect students' individual health screening forms daily at the bus stop or at arrival entrances. Parents should continue to report symptoms and call the Health Office with questions.

Chautauqua Lake Central School COVID-19 Screening Form For Students

1. Does your child have a temperature of 100°F or higher or is your child experiencing any of the following symptoms?
   • Sudden onset of loss of taste or smell
   • Sore throat/cough
   • Congestion or runny nose
   • Nausea/vomiting or diarrhea
   • Shortness of breath or trouble breathing
   • Severe headache
   • Chills
   • Muscle or body aches.
   *Check “No” if the nature of the symptom (duration, intensity, etc.) is consistent with a pre-existing condition of which you are already aware that is not new, worsening, or different from its usual presentation. (i.e., seasonal allergies, asthma, migraine headaches, IBS, Crohn’s Disease)    
2. Has your child...
   • knowingly been in close or proximate contact in the past 14 days with anyone who has tested positive through a diagnostic test for COVID-19
   • tested positive through a diagnostic test for COVID-19 in the past 14 days?

*If you answer yes to any question above, please do not allow your child to get on the bus or enter the school.