I'm a Student
I'm a Visitor or a Family Member
I’m a non-DOE Staff/Contracted Provider
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School or Facility You're Entering
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Fill Out Daily Screening
Have you experienced any symptoms of COVID-19, including a fever of 100.0 degrees F or greater, a new cough, new loss of taste or smell or shortness of breath that started in the past 10 days?
Yes, and I have received a lab-confirmed negative result from a COVID-19 diagnostic test (not a blood test) since the onset of symptoms AND have not had symptoms for at least 24 hours.
Yes, and I am not in the category above.
In the past 10 days, have you gotten a lab-confirmed positive result from a COVID-19 diagnostic test (not a blood test) that was your first positive result OR was AFTER 90 days from your previous positive result? Please note that 10 days is measured from the day you were tested, not from the day when you got the test result.
To the best of your knowledge, in the past 10 days, have you been in close contact
(within 6 feet for at least 10 minutes over a 24 hour period)
with anyone who tested positive for COVID-19 for their first time or who has been told they have symptoms of COVID-19? Clinical staff who were in appropriate PPE are not considered close contacts in these scenarios.
In the past 10 days, have you returned from a country with a
CDC level 2 or higher health alert
US state or territory
other than New Jersey, Pennsylvania, Connecticut, Massachusetts, or Vermont?
Yes, I was out of state for less than 24 hours, and I took or will take a COVID-19 test on the 4th day after my arrival in New York.
Yes, I was out of state for more than 24 hours, and I took a COVID-19 test within 72 hours PRIOR to my arrival in New York, quarantined for at least three days upon my arrival in New York, and took a second COVID-19 test on the 4th day AFTER my arrival, and got negative results on both tests.
Yes, and I am not in the two categories above.
This Health Screening is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Health screening results will be reviewed for the sole purpose of gaining access to facilities and confidentiality will be maintained.
COVID-19 Testing Consent
As part of our efforts to keep schools safe, we are testing randomly selected students, staff and guests in schools for COVID-19. In order for us to administer a COVID-19 test to you, we need your consent. Please review our webpage on
COVID-19 Testing for Students and Staff
before submitting your consent.
Do you consent that a COVID-19 test can be administered to you?
Download a printable version of this questionnaire