COVID-19 Screening Declaration – pupils

To help prevent the spread of COVID-19 and in line with Government guidance, we are required to conduct this simple screening declaration. Your participation is important to help us take precautionary measures to protect you and everyone associated with Luckley.


I hereby certify that this pupil has not within the last 14 days:

  • Tested positive with the Coronavirus or been identified as a potential carrier
  • Experienced any symptoms commonly associated with the Coronavirus
  • Been in any location designated as a risk by the Government or Public Health England
  • Been in direct contact with or in the immediate vicinity of any person been identified as a carrier or potential carrier of the Coronavirus.
  • Not visited any regions/countries that require a quarantine upon return.