Daily Health Self-Assessment for Blackhawk School District
Due to the highly infectious nature of COVID-19, BSD students should do a daily
health self-assessment before arriving at school for class. This self-assessment should
not take the place of talking with your healthcare provider to diagnose or treat conditions.
This assessment is based on guidance provided by the Centers for Disease Control and Prevention (CDC).
1. Have you had close contact with someone who is positive for COVID19? Y/N
2. Are you or anyone in your household awaiting the results of a COVID19 test? Y/N
3. Have you and/or someone in your home traveled in the last 14 days? Y/N
*Traveling to an area of high risk requires a 14 day quarantine per the Pa Deptartment of Health*
4. Have you taken any fever reducing medication in the past 24 hours? Y/N
5. Have you had any ONE of the following in the last 24 hours? Y/N
a. new or worsening cough
b. shortness of breath
c. difficulty breathing
d. new or loss of taste/smell
6. Have you had any TWO of the following in the last 24 hours? Y/N
a. fever (100.4 or higher)
b. chills
c. muscle pain
e. Headache
f. Sore throat
g. nausea/vomiting
h. diarrhea
i. fatigue
j. congestion or runny nose
If your child has answered YES to any of the above questions, keep your child home. Please call the principal and contact one of the following School Nurses:
Ms. Hullihen, RN, BSN, CSN Mrs. Haddox, RN, BSN CSN
[email protected] [email protected]
724-846-9600 x2005 724-843-1700 x3004