North Lakeland School District - COVID-19 Visitor Reporting

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First & Last Name

Phone Number

Expected Date of Visit to NLS

Reason for Visiting NLS

Have you been around someone who has tested positive for Covid-19, or is awaiting a test result, in the last 14 days?

(1 required)

Yes

Have you recently been around anyone who is currently experiencing any of these symptoms?

(1 required)

Fever or Chills

Cough, Shortness of Breath or Difficulty Breathing

Fatigue

Muscle or Body Aches, Headache

New Loss of Taste or Smell, Sore throat, Congestion or Runny Nose

Nausea or vomiting, Diarrhea

NONE

What is your current temperature?

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