Somerville Weekly Parent Health Agreement

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All responses must be submitted by Monday morning (9:30 am) of each week.

Email *

Name of person submitting agreement form. *

Family last name of child/children *

I will check my child/children daily for signs and symptoms of illness. I will check my child/children's temperature daily. I will keep my child/children home if they present with any signs or symptoms of illness. I will not send my child/children back to school until they are symptom free for 24 hours without medications. If I have traveled to a "hotspot" state, I will self-quarantine my child/children for 14 days. *

I agree

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A copy of your responses will be emailed to the address you provided.

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