Operoo

Holland Central Schools: Student COVID Weekly Check-in Form

PLEASE NOTE - this form should only be used if you are having issues with your Operoo account.

Each child needs to have an individual form completed daily.

Student Name: *

Parent Name: *

Date *

School Building (single response accepted) If you have another child, another form must be completed) *

Elementary School

Middle School

High School

Have you experienced symptoms of COVID-19 such as fever (temperature of 100°F or above), chills, rigors, muscle aches, headache, back pain, fatigue, runny nose, congestion, sore throat, loss of smell, loss of taste, shortness of breath, difficulty breathing, wheezing, chest pain, cough, abdominal pain, nausea, vomiting, diarrhea, dehydration, altered mental status/confusion, or seizures in the past 10 days? Please answer “yes” only if you are experiencing a new onset of symptoms OR you are experiencing a change in symptoms from your baseline if you have a known preexisting medical condition (e.g. asthma, allergies). *

Yes - You cannot come to school today.

Is your temperature 100 degrees Fahrenheit or greater today? *

Yes - You cannot come to school today.

In the last 10 days, have you tested positive for COVID-19 or are you still waiting for the test result? *

Yes - You cannot come to school today

Have you had contact with anyone confirmed or suspected of having COVID-19 in the past 10 days? *

Yes - You cannot come to school today, unless you are fully vaccinated.

Acceptance *
Parent/Guardian Attestation

I confirm that my child is not showing symptoms and has replied "NO" to all questions above.

I confirm that my child is showing COVID symptoms, or has replied "YES" to one or more questions above.

Your Name

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