Daily Symptom Checklist Revised January 2022

Revised 1/2/22


Please complete this checklist each morning.


Do you have a:

❏ Fever (temperature over 100.0 F), chills, or shaking chills, without having taken any fever reducing medications?

❏ Difficulty breathing or shortness of breath

❏ New lost of taste or smell

❏ Muscle aches or body aches

❏ Cough (not due to other known cause, such as chronic cough)

❏ Sore throat, when in combination with other symptoms

❏ Nausea, vomiting, or diarrhea, when in combination with other symptoms

❏ Headache, when in combination of other symptoms

❏ Fatigue, when in combination with other symptoms

❏ Nasal congestion or runny nose (not due to other known causes, such as allergies), when in combination with other symptoms


Unvaccinated Individuals:

  • Presenting with any of these symptoms should stay home and call your primary care provider or school nurse for guidance on COVID testing


Vaccinated Individuals:

  • Presenting with any symptoms in bold should stay home and refer to their primary care provider to assess the need for COVID testing

  • Presenting with a COMBINATION of symptoms should stay home and monitor symptoms but refer to their primary care provider if symptoms do not improve or worsen

  • Who have been identified as a close contact, should monitor themselves but refer to their primary care provider for COVID testing if they have any symptoms


  • Testing will not be done at school for students who upon arrival to school are presenting with multiple symptoms. Those students will be dismissed and referred to their primary care provider for evaluation and possible testing.

  • Students with multiple symptoms in any category should be kept home, monitored and referred to their primary care for evaluation and recommendations for testing.


If there is a reasonable question on the antigen test results, PCR confirmation is recommended. This is most likely to happen when a highly symptomatic individual has a negative test, unless there is an alternative diagnosis. If the results are discordant, for the purposes of these protocols the PCR result would be taken as the true result, assuming the two tests are done within 2 days of each other.


Revised and published 1/3/22