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Covid-19 Health Declaration

To help prevent the spread of COVID-19, every child/family must complete and sign this form before returning to our nursery. N.B. Every question must be answered.

Does your child have symptoms of: cough, fever, high temperature, sore throat, runny nose, breathlessness, loss of sense of taste or smell or flu like symptoms now or in the past 14 days?
Does your child have symptoms of: cough, fever, runny nose, sneezing, diorrhea, vomiting in the last 24 hours?
Has your child been diagnosed with confirmed or suspected COVID-19 infection in the last 14 days?
Is your child a close contact of a person who has a confirmed or suspected case of COVID-19 in the past 14 days (i.e. less than 2 metres for more than 15 minutes accumulative in 1 day)?
Has your child been advised by a doctor to self-isolate at this time?
Have you given any anti-febrile medication to your child in the last 24 hours?
Has your child traveled outside of the island of Ireland in the last 14 days?

Thanks for submitting!

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