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Health Certification Form

A form for parents to certify children are healthy for school every day

Dallas City Elementary must perform a health screening for each person, staff and student, prior to entry to the school building or loading a school bus.  Parents have the option of completing the health screening at home.  Simply print the Health Certification forms and cut them out to make 10 certificates. Check your child's temperature and perform a health screening by ensuring your child does not have the symptoms printed on the certificate.  Then write your child's name on the Health Certification form, sign it, and send it to school with your child.  Your child will be asked to present the Health Certification form to the staff member either on the bus or at the school building.  A staff member will perform the health screening including a check of the student's body temperature for each child that does not present a Health Certification form.  A copy of the Health Certification forms can be found by clicking here.    More forms will be sent home with students each week.  If you would like to pick up a copy of the Health Certification form, you may pick one up at the school office.  If your child has ANY of the symptoms listed on the certificate or has been in contact with an individual diagnosed with COVID-19, please DO NOT send your child to school.


Dallas City Elementary Health Certification Form