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Fall 2 Daily CV-19 Monitoring Form
*Regarding Travel Out of State within prior 2-weeks - It is the family's responsibility to follow MA DPH and Newton HHS travel guidelines.

*If you answer YES to any of the following questions then you are not allowed to practice or participate in games until cleared by the Newton South Health Department.
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Student Name (Last Name, First Name) *
SPORT *
FEVER *
Required
Cough *
Required
Sore Throat *
Required
Shortness of Breath *
Required
Recent Loss of Taste or Smell *
Required
Close Contact with someone COVID-19 Positive *
Required
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