Republic of the Philippines

Department of Education
Caraga Region
SCHOOLS DIVISION OF SURIGAO DEL SUR
Cagwait District

Orientation of Clinic Teachers on Clinic

Management and Reporting for
Expanded face to face Classes
March 16, 2022
UNIDAD national High school
Different forms to be used
during f2f classes
1. Parent Consent
2. Paalala sa Magulang
3. Pupils Medical Record
4. Notice to Reporting Personnel
5.Visitor’s Health Declaration Form
6.Daily Health Monitoring Form
7.Logsheet
8. School Head’s Summary
9. May Go Home Slip
10.Referral Slip
11. Prescription Instruction Slip
 Tool Description
Para sa mga For distribution to parents of learners who
Magulang will report to school; may be part of the
parent's consent that they will sign in
approving learner's physical reporting to
school

Notice to Reporting For display at the entrance gate and/or for

Personnel distribution to reporting personnel (may be
signed at least once)
Visitor's Declaration For visitors who will enter the school; to be
Form accomplished by the visitor and assessed
properly by designated school staff prior to
approval of entry (there must be guidelines
as to when visitors may be accommodated
and for what identified purposes)
Teacher's Record For teachers to keep per class, each
day, during health routine inspection
(teacher may be provided with step-
by-step instruction on how to
facilitate the inspection using the
tool)
Logsheet For safekeeping at the Clinic c/o the
Clinic Teacher/Nurse to record all
cases managed at the Clinic
School Head's The school head shall keep a
Summary summary of the health status of
learners and personnel, especially
those who will manifest COVID-19
symptoms for proper monitoring and
identification of necessary next
steps
 Symptoms Translation/Description
Fever Lagnat/ang body temperature
ay 37.5 C o higit pa
01
02 Cough Ubo
03 General weakness Panghihina ng katawan
04 Fatigue/Tiredness Pagkapagod
05 Headache Pananakit ng ulo
Muscle/joint/body pains Pananakit ng katawan,
06 kalamnan, kasu-kasuan
Sore throat Pananakit o pamamaga ng
07 lalamunan
08 Colds/runny nose Sipon
Difficulty of breathing
09 Pagkahapo o hirap sa paghinga
10 Loss of appetite Kawalan ng ganang kumain
11 Nausea Nasusuka
12 Vomiting Pagsusuka
13 Diarrhea Pagtatae
14 Loss of smell Pagkawala ng pang-amoy
15 Loss of taste Pagkawala ng panlasa
Rashes Mga butlig sa balat; pamumula
ng balat (maaaring makati o
16 hindi)
Others
Mga sintomas o obserbasyon sa
pangangatawan o pagkilos ng
tao/bata na kailangan ng
17 atensyong medikal