Student Daily Health Check

During the COVID-19 pandemic, we have taken many proactive measures to ensure the health and safety of our campus community. An important step, in line with guidelines from the Commonwealth of Kentucky, is to check symptoms of all people entering campus to confirm they are free of certain symptoms related to COVID-19.
Daily Health Check
The College is using self-administered checks for all campus community members. This form must be completed every day that you are on campus. Optimally, this check should be performed prior to beginning classes or practices each day to minimize the spread of COVID-19.
Student Name*
Student Email Address (include @kwc.edu)*
Date*
MM slash DD slash YYYY
Screening Questions
These questions are taken from the Kentucky Healthy at Work guidance at https://govstatus.egov.com/ky-healthy-at-work and the CDC symptoms list at https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html.
1. Since your last day on campus, have you had any of the following CDC-recognized COVID-19 symptoms that are new or unexplained: fever or chills, cough, shortness of breath or breathing difficulty, fatigue, muscle or body aches, headache, loss or taste or smell, sore throat, congestion or runny nose, nausea or vomiting, or diarrhea?*
For the purposes of the COVID-19 pandemic, a fever is a termperature above 100.4 degrees.
- Yes
- No
2. Is there anyone in your household who is showing new or unexplained COVID-19 symptoms or who has been diagnosed with COVID-19?*
- Yes
- No
3. Have you been in close contact with anyone exhibiting new or unexplained signs or symptoms of fever, persistent cough or shortness of breath consistent with COVID-19 who has not been tested or is still awaiting testing?*
- Yes
- No
4. Have you received a full course of COVID-19 vaccine (two shots for Pfizer or Moderna, one shot for Johnson and Johnson) and are at least two weeks from the final shot?*
- Yes
- No
"Yes" response and not Vaccinated
If you answered “yes” to any of the screening questions, you should contact Student Health Services, your professors and follow current Kentucky Department for Public Health and/or CDC guidelines available at: https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-whensick.html.
All "No" responses and Vaccinated
If you answered “no” to all of the screening questions and are fully vaccinated, you should continue to self-monitor during the day and, if you develop symptoms, you should report those symptoms to your Student Health Services.
Confirmation*
I confirm the above information is true and accurate to the best of my knowledge.

Daily Health Check

Screening Questions

"Yes" response and not Vaccinated

All "No" responses and Vaccinated