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COVID-19 Health Screening Agreemnet

Instructions for Parents and/or Guardians

For the health and safety of our students, LOCS asks for students to be screened for symptoms of COVID-19 before getting on a bus or entering school. The Centers for Disease Control and Prevention (CDC) do not recommend screenings be done by the schools in consideration of time and interruption to education. Schools may conduct additional in school screening if cases have been identified in the school or prior to after school activities.
Complete the one-time information below prior to sending your child to school. By doing so, you indicate your understanding and agreement to perform daily symptom screenings on your child. By signing this form, I am committing to screening my child daily for the 2021-2022 school year, unless otherwise directed. I also understand that it is my responsibility to call the school immediately if my child is not going to school for potential COVID-19 symptoms.
I commit to screening my child daily for COVID-19 symptoms and exposure.
Parent/Guardian SignaturerequiredBy clicking this box, you will comply with the LOCS health and screening protocols each day.​
By clicking this box, you will comply with the LOCS health and screening protocols each day.​