COVID-19 Screening Form

The (JICS) Lab School Parent/Guardian Daily Screening
Reproduced from signed form in SFO - Updated September 18, 2020

As a Parent/Guardian, you must prevent the spread of illness by keeping your child home from school if your child experiences any of the following signs or symptoms listed below.

Some people may experience mild or no physical symptoms. Symptoms can take up to 14 days after exposure to COVID-19 to appear, and include new or worsening:


Common symptoms of COVID-19 include:

  • Fever

  • Cough

  • Difficulty breathing

  • Sore throat

  • Runny nose

  • Loss of taste or smell

  • Nausea, vomiting, diarrhea

  • Difficulty swallowing

If you are having difficulty breathing, call 911.


Disease symptoms may be different, depending on age. Children and older adults with COVID-19, may also have non-specific symptoms, such as:

  • disorientation, confusion

  • sleeping more than usual or muscle aches

  • dizziness, weakness or falls

  • chills, headaches


Rarely, children can get an inflammatory condition that impacts the blood vessels, called vasculitis. It can present with prolonged fever, abdominal pain, red eyes, nausea, vomiting, diarrhea, and rash. It needs medical attention.


For others, there is a higher risk for severe illness, including people over the age of 60, and those with weakened immunity or underlying health conditions.


If your child experiences any of the symptoms while at school, staff will contact you or one of your emergency contacts to pick up your child immediately. While your child waits for you or your designate to arrive, they will be separated from the other children.


As a Parent/Guardian responsible for my child, I agree to the following:


  • I have read and understood the above information.

  • I understand the risk of illness associated with placing my child in the School.

  • I understand that if my child has one or more (new or worsening) symptoms of COVID-19, they will stay at home, self-isolate, and get tested. I will contact the JICS Lab School to let the School know that my child has COVID-19 symptoms.

    Household members should monitor for symptoms for 14 days. They can go to school or work if they do not have symptoms and the child with symptoms has not tested positive for COVID-19. This includes while you are waiting for the test results. If your child has symptoms and was a close contact of someone who had COVID-19 then household members should stay home and self-isolate.

    Contact your child’s health care provider if you have questions about testing. Find an Assessment Centre near you to get tested. Children can often get a throat swab or swab at the tip of the nose so it is more comfortable than a deep nasal swab.  When going to an assessment centre, don’t use public transit. Drive your child if you can, ask for a ride, or use a taxi or ride share. Wear a mask, sit in the back seat, and keep the windows open. You can check your test results at by clicking on “check your lab results.” Results can take a few days.

  • I understand that if my child tests negative for COVID-19:
    My child may return to School after they have no symptoms for 24 hours.
    Young children may have ongoing mild symptoms, such as a runny nose. If it is not new or worse, they may go back to school if they don’t have other symptoms.

  • I understand that If my child tests positive for COVID-19:
    My child must stay home and self-isolate for 14 days from the day the symptoms started.
    Household members and close contacts must also self-isolate for 14 days.
    I will let the JICS Lab School know that my child tested positive for COVID-19.
    Toronto Public Health will contact me to do an investigation and with further instructions.

  • I understand that If my child has COVID-19 symptoms and did not have a COVID-19 test, they must stay home and self-isolate for 14 days from the day the symptoms started. Even if their symptoms get better sooner, they will stay home for 14 days. Household members will continue to self-monitor for 14 days. Household members can continue to attend school or work as long as they do not have any symptoms.

  • I understand that sometimes children are sick for other reasons and if our health care provider has ruled out COVID-19, my child may return to school once they are free of all symptoms for 24 hours.

  • I understand that if anyone in my household has travelled outside of Canada or has been in close contact with anyone who has traveled outside Canada in the past 14 days, I will immediately exclude my children from School until a minimum period of 14 days has passed after the date of return to Canada.

  • I understand that if I have questions, I will contact Toronto Public Health at 416-338-7600.

  • I agree to the screening requirements and to accurately carry out the daily screening. Misrepresentation regarding the information provided to the JICS Lab School could result in exclusion of the child from the School.

  • Upon request by the JICS Lab School, I consent to providing copies of my child’s COVID-19 test results to the University of Toronto Occupational Health Nurse.

  • This agreement remains in effect for the duration of the 2020/21 school year.

COVID-19 Screening Form & Related Documents

Please print and display the posters below in your home as a daily reminder of protocols to follow to keep yourself and our community safe.



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© Copyright 2017 by Jackman Institute of Child Study.

Contact Us

Lab School Office:

416 934 4517
ICS After School Daycare:
416 934 4522


45 Walmer Road

Toronto, ON M5R 2X2