Daily Health Check Form
CDC guidance, for child care programs that are open during the COVID-19 pandemic, includes asking parents to confirm that their children do not have fever (100.4°F), shortness of breath, or cough before bringing them to the center. Additional symptoms of COVID-19 identified by CDC are chills, difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea. Guidestar Forms is offering a Daily Health Check Form for centers want parents to document confirmation that their children do not have symptoms of COVID-19 or other illness.
Parents complete a Daily Health Check Form in seconds on a smart phone, tablet, or computer before bringing their children to the center. Submission date and time are automatically recorded. In the form parents confirm that their children do not exhibit specified symptoms. We can add a field for parents to enter the child’s temperature if you would like to record it as well. We developed two sample forms, each of which will be customized to meet your needs.
Click here to test drive Daily Health Check Form sample #1
Click here to test drive Daily Health Check Form sample #2
Upon submission, a notification email message with the child’s name in the subject line is sent to a designated address so a staff member can quickly validate the parent’s confirmation on a smart phone, tablet, or computer. If child arrivals are divided into groups (e.g., arrival time, class, drop off location), parents indicate which group their children are assigned to. Separate email accounts for each group receive notifications facilitating validation before accepting the children for the day.
Administrators periodically export and archive daily health check records. Export frequency depends on the number of children arriving each day and Daily Health Check Form capacity.
Guidestar Forms is offering special pricing to ensure that the Daily Health Check Form is affordable for all subscribers at what we know is a difficult time. For organizations that include the Daily Health Check Form in a subscription including other forms, the annual subscription fee schedule is:
$100 for capacity of 100 submissions
$0.20 for each additional submission above 100 up to capacity of 2000 submissions
$0.10 for each additional submission above 2000
Organizations that only subscribe to the Daily Health Check Form pay an additional $160 annual account maintenance fee.
This chart provides examples of number of children arriving daily, export frequency, capacity (#), and associated annual subscription fee ($).
Parents complete a Daily Health Check Form in seconds on a smart phone, tablet, or computer before bringing their children to the center. Submission date and time are automatically recorded. In the form parents confirm that their children do not exhibit specified symptoms. We can add a field for parents to enter the child’s temperature if you would like to record it as well. We developed two sample forms, each of which will be customized to meet your needs.
Click here to test drive Daily Health Check Form sample #1
Click here to test drive Daily Health Check Form sample #2
Upon submission, a notification email message with the child’s name in the subject line is sent to a designated address so a staff member can quickly validate the parent’s confirmation on a smart phone, tablet, or computer. If child arrivals are divided into groups (e.g., arrival time, class, drop off location), parents indicate which group their children are assigned to. Separate email accounts for each group receive notifications facilitating validation before accepting the children for the day.
Administrators periodically export and archive daily health check records. Export frequency depends on the number of children arriving each day and Daily Health Check Form capacity.
Guidestar Forms is offering special pricing to ensure that the Daily Health Check Form is affordable for all subscribers at what we know is a difficult time. For organizations that include the Daily Health Check Form in a subscription including other forms, the annual subscription fee schedule is:
$100 for capacity of 100 submissions
$0.20 for each additional submission above 100 up to capacity of 2000 submissions
$0.10 for each additional submission above 2000
Organizations that only subscribe to the Daily Health Check Form pay an additional $160 annual account maintenance fee.
This chart provides examples of number of children arriving daily, export frequency, capacity (#), and associated annual subscription fee ($).
