Hofstra University Visitors - Mandatory Health Screening Questionnaire
Campus Visitors: In accordance with NY State requirements, as well as following best practices for the safety and health of our community, the University is implementing this health screening for visitors coming onto Hofstra's campus.

IMPORTANT: If you are a Hofstra STUDENT or EMPLOYEE – Do not complete this visitor form. Please complete the mandatory health screening for students/employees. Please access it via: https://my.hofstra.edu/web/home-community/mandatory-health-screening-questionnaire

IMPORTANT: If you answer YES to any of the three questions below, you are prohibited from entering Hofstra University's campus.

For questions about this screening questionnaire, please contact safestartHR@hofstra.edu.
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Name *
If applicable, please enter your company/organization.
Please enter the best phone number to reach you if we need to contact you *
Date of your campus visit. *
MM
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DD
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Time of your campus visit.
Time
:
What is the reason for your visit?
If applicable, what is the name of the department or person you are visiting on campus?
Indicate if you have experienced ANY of the symptoms potentially related to COVID-19 within the past 14 days.  Symptoms include: new cough not related to chronic condition, shortness of breath or difficulty breathing, fever, chills, muscle pain (not related to chronic condition), sore throat, new loss of taste or smell, conjunctivitis (pink eye), any redness, swelling, itchiness or discharge from eye(s), runny/stuffy nose/nasal congestion (not related to allergies or relieved by antihistamines), diarrhea (not related to chronic condition), nausea and/or vomiting, headache (not related to chronic condition), fatigue (not related to chronic condition). Please note that if you have received a COVID-19 vaccine within the past 4 days it may be normal to experience symptoms of fatigue, headache, and muscle and joint achiness.  Please respond YES to ONLY new loss of taste or smell, fever or chills, or difficulty breathing during this post-vaccine period, as these symptoms may require further evaluation.) *
Have you tested positive for COVID-19 within the past 14 days? *
Have you knowingly had close or proximate contact with someone in the past 14 days who has tested positive for COVID-19 or who has had symptoms of COVID-19 (see above for list of symptoms)? *
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