Hawthorne Elementary School Visitor Sign-In
Welcome to Hawthorne School!  

In order to make your experience on our campus a safe one, please note that mask wearing is mandatory indoors. Every guest must also complete this form before physically entering any BHUSD property. If you do not pass the Health Screening, or your temperature measures 100.4°F or higher, you will not be allowed to enter campus.
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Last Name *
First Name *
Phone Number (xxx-xxx-xxxx) *
Email Address *
In the last 24 hours, has the person entering campus experienced any of the following symptoms not due to a chronic condition eg. allergies? - New Loss of Taste or Smell- Unusual Fatigue- Unusual Runny or Stuffy Nose- Fever over 100.4 °F- New or Unusual Headache- New Cough- New Sore Throat- Shortness of breath/ Difficulty breathing- Chills- Muscle or Body Aches- Gastrointestinal symptoms (nausea, vomiting, or diarrhea) *If you answer yes you have not passed the Health Screening, you are not permitted to enter any BHUSD premises. * *
In the last 10 days, have you or anyone in your household had close contact with someone who has or is suspected to have COVID-19? *If you answer yes you have not passed the Health Screening, you are not permitted to enter any BHUSD premises. * *
I confirm that the information given in this form is true, complete and accurate. * *
Signed (your name) * *
If you do not pass the Health Screening or your temperature measures 100.4°F or higher you cannot come on campus.
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