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Rock the Baby

Self-Screen Form

This assessment must be done the morning of, before arriving to school each day.

A child/staff member/person will not be allowed to enter the classroom until this form is received.

Forms must be submitted each day one is due into school, even if not attending. 

Forms should be submitted at least 20 minutes before one is due to arrive.

If not attending, the form must be submitted by no later than 8:30am.

If a person has any symptoms listed below, they might not be able to attend school until permitted by Rock the Baby. Your classroom will contact you when necessary.

All persons above the age of 2 years old must wear a mask covering their nose and mouth when entering and exiting the building. 

Please remember to distance when other families are by the entrance.

Thank you so much!

If any of the below are checked off as a yes response, the person may not be able to attend school until permitted by RTB. The child/staff/person has or as had in the last 24-48 hours:
Will be ABSENT today -The child/staff/person will not be attending school today due to:
Will ATTEND school today -The child/staff/person:
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