AP Online Forms: Creating a Home Health Screening Form

Creating a home health screening form in AdminPlus Online Forms can be approached as a three-step process:

  1. Create a SuperDB Table for Health Screening Data.
  2. Create the Health Screening SuperDB Fields.
  3. Create an AdminPlus Online Form for Health Screening.

Each time a parent submits this form, a document is added to the portfolio. You should clear out these documents periodically. To learn how to batch delete portfolio documents, see Batch Delete Portfolio Items.

In this article, we are creating the Centers for Disease Control and Prevention form, Daily Home Screening for Students. This particular form only contains checklist items, so our form will follow that format using validated fields to provide parents with a yes-no selector for each checklist item; however, you can choose to accept more detailed data. For example, for the checklist item "[t]emperature 100.4 degrees Fahrenheit or higher when taken by mouth," you could choose to accept temperature values.

The Online Form we create based on the CDC form will combine the two sections shown in the table below, resulting in a form of eight yes-no questions as well as one auto-filled date field.

Section 1: Symptoms Section 2: Close Contact/Potential Exposure
Temperature 100.4 degrees Fahrenheit or higher when taken by mouth Had close contact (within 6 feet of an infected person for at least 15 minutes) with a person with confirmed COVID-19
Sore throat Traveled to or lived in an area where the local, Tribal, territorial, or state health department is reporting large numbers of COVID-19 cases as described in the Community Mitigation Framework
New uncontrolled cough that causes difficulty breathing (for students with chronic allergic/ asthmatic cough, a change in their cough from baseline) Live in areas of high community transmission (as described in the Community Mitigation Framework) while the school remains open
Diarrhea, vomiting, or abdominal pain  
New onset of severe headache, especially with a fever  

Step 1: Create a SuperDB Table for Health Screening Data

  1. On the toolbar, click View > SuperDB.
  2. In the SuperDB dialog box, in the left pane, under Setup, click Create Table.
  3. In the Define Table dialog box, do the following:

    Define SuperDB Table Basic Specifications

    Define Table: Basic Specifications
    A

    Enter a Table Name. For example, "Health Screening."

    This field is limited to 20 characters.

    B

    Enter a Description of the data this table will store. For example, "Home health screening results."

    This field is limited to 50 characters.

    C Next to Create one record with default values, select the All Students check box.
    D
    1. In the Length/Record drop-down, select (Custom...).

      The Define Custom Record Length dialog box appears.

    2. In Enter Record Length, type "10000" to set the maximum length.
    3. Click Done.
  4. Proceed to the table below the Define Table specifications to create the fields for the Health Screening Form.

Step 2: Create the Health Screening SuperDB Fields

  1. In the Define Table dialog box, in the data table, click Item Name and create the 9 fields for the Health Screening Form by entering the settings as shown in the table below. Press Tab to progress through the fields.

      Define Table: Field Settings for the Health Screening Form
    # Item Name Type Length Required Case Validation Default Value
    1 Temp > 100.3 Text 3 Optional Leave As Is Supervisor Only  
    2 Sore Throat Text 3 Optional Leave As Is Supervisor Only  
    3 Uncontrolled Cough Text 3 Optional Leave As Is Supervisor Only  
    4 NVD/Abdominal Pain Text 3 Optional Leave As Is Supervisor Only  
    5 Headache/Fever Text 3 Optional Leave As Is Supervisor Only  
    6 Close Contact Text 3 Optional Leave As Is Supervisor Only  
    7 Travel Risk Text 3 Optional Leave As Is Supervisor Only  
    8 Comm. Transmission Text 3 Optional Leave As Is Supervisor Only  
    9 Submit Date Date 10 Optional N/A N/A <TODAY>
  2. Press Enter to save your progress.
  3. Click Temp > 100.3, and then click Setup Validation [F6].

    Define SuperDB Fields and Validations

  4. In the Enter Acceptable Values dialog box, click Add [F2], and do the following:

    • Type "No" and press Enter.
    • Type "Yes" and press Enter.
  5. Press Accept [F10], and then click Done [F10].
  6. Repeat this process for each SuperDB field, except Submit Date, to set up the field validations.

Step 3: Create an AdminPlus Online Form for Health Screening

  1. On the toolbar, click Tools > AP Online Forms Manager.
  2. In the Administrator's Plus Online Forms Manager, click 3. Create/Edit Online Forms, and then click A. Create and Edit Forms.
  3. In the Create and Edit Forms dialog box, click New Form [F2].
  4. In the Add New Online Form dialog box, under Specifications: <New Form> do the following:

    Create Health Screening Form

    Form Specifications
    Student or Staff Click Student.
    Form Name

    Enter "Health Screening Form."

    On Forms Show As

    Enter "Health Screening Form."

    Form Type

    Click Generic.

    Enable Resubmitting the Form Select the check box.
  5. Click Next: Add Pages [F10].
  6. In the Add New Page dialog box, set the following specifications:

    If you aren't in the Add New Page dialog box, in the Add Pages to the Online Form dialog box, click New Page [F2].

    Add Page to Health Screening Form

    Page Specifications
    Page Name

    Enter "Health Screening Form."

    On Forms Show As

    Enter "Health Screening Form."

    Tab Name (15 Char.) Enter "Health Check."
    Page Instructions

    Enter instructions for parents filling out this form. See the CDC's form for an example that you can customize for your school.

  7. Click Next: Add Sections [F10].
  8. In the Add New Section dialog box set the following specifications for the Symptoms & Close Contact/Potential Exposure section:

    If you aren't in the Add New Section dialog box, in the Add Sections to the Page dialog box, click New Section [F2].

    Add Section to Health Screening Form

    Section Specifications
    Section Name

    Enter "Symptoms and Close Contact/Potential Exposure."

    Type Select SuperDB Linked from the drop-down.
    On Forms Show As

    Enter "Symptoms and Close Contact/Potential Exposure."

    Instructions

    Enter instructions for parents filling out this section. See the CDC's form for an example that you can customize for your school.

    In your instructions, you should urge parents to click Add Another to fill out a new Health Screening Form each day. If they do not click Add Another to fill out a new form, their previous entries will be overwritten.

    SuperDB Table

    Select Health Screening from the drop-down.

    If you assigned a different name to your SuperDB table, select that item from the drop-down instead of "Health Screening."

    Enable "ADD ANOTHER"

    Select the checkbox.

    If you don't Enable "ADD ANOTHER" in the specifications, parents will not have have the option to Add Another on the Health Screening Form. They will overwrite their previous answers to the Health Screening Form each time they complete it, and you will not collect a record of their responses. In your instructions, you should urge parents to click Add Another to fill out a new Health Screening Form each day.

  9. Click Next: Add Questions [F10].
  10. In the Select One or More Fields from SuperDB Table dialog box, press and hold Ctrl, click each of the following fields, and then press Enter:

    Select Questions from SuperDB Table

    Questions for Section 1: Symptoms
    # Item Name How Should This Field Appear on the Form Mandatory
    001 Temp > 100.3 Temperature 100.4 degrees Fahrenheit or higher when taken by mouth Yes
    002 Sore Throat Sore throat Yes
    003 Uncontrolled Cough New uncontrolled cough that causes difficulty breathing (for students with chronic allergic/asthmatic cough, a change in their cough from baseline) Yes
    004 NVD/Abdominal Pain Diarrhea, vomiting, or abdominal pain Yes
    005 Headache/Fever New onset of severe headache, especially with a fever Yes
    006 Close Contact Had close contact (within 6 feet of an infected person for at least 15 minutes) with a person with confirmed COVID-19 Yes
    007 Travel Risk Traveled to or lived in an area where the local, Tribal, territorial, or state health department is reporting large numbers of COVID-19 cases Yes
    008 Comm. Transmission Live in areas of high community transmission while the school remains open Yes
    009 Submit Date Submit date Yes
  11. In the Add Questions to the Section dialog box, go through the questions in the table, make them Mandatory, and update the text for How Should This Field Appear on the Form based on the table above.
  12. Click Finish [F10].

    You can preview your form by going back to the Forms tab of the Create and Edit Forms dialog box and clicking Preview Online Form (or pressing F12).