Self-Screening: Basic Information

The safety of the Monongalia County Schools community is our top priority. As the COVID-19 pandemic continues to evolve, we are monitoring the situation closely and will periodically update its policies and procedures based on current guidance from the Centers for Disease Control and Prevention (CDC) and other federal, state and local agencies.

To help prevent the spread of COVID-19 and reduce the potential risk of exposure to our students and staff, we need you to complete this simple questionnaire daily before sending your student to school or before reporting to work. Your participation is important to help us take precautionary measures to protect you and other members of our community.

The information you provide will be shared with your school Principal or department administrator, school nurse, and Supervisor of School Health.

You can make this form an "app" on your phone or tablet!

From Chrome for Android:

Tap the menu button and tap Add to homescreen. You’ll be able to enter a name for the shortcut and then Chrome will add it to your home screen.

iOS:

Tap the Share button on the Safari toolbar — that’s the rectangle with an arrow pointing upward. It’s on the bar at the top of the screen on an iPad, and on the bar at the bottom of the screen on an iPhone or iPod Touch. Tap the Add to Home Screen icon in the Share menu.

FIRST Name (of MCS staff or student) *

LAST Name *

Today's Date: * +

Are you a/an:

*If you are a parent answering for your child, please mark STUDENT.

Student

Staff

Pre-K	K
01	02
03	04
05	06
07	08
09	10
11	12
Adult