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FJC Hebrew School Health Screening
This form must be completed prior to class arrival in instances where the NYCDOE Daily Health Screening Form is unavailable. The completed list will be available to the teacher so that she can ensure that all students have been screened prior to the start of class.
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* Indicates required question
Email
*
Your email
Student Name
*
Your answer
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 within the past 10 days?
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No. Continue to next question.
Yes, and I have received a negative result from a COVID-19 test since the onset of symptoms AND have not had symptoms for at least 24 hours
Yes, and I’m not in the category above. No further screening will be required, you will not be able to join class today.
In the past 10 days, have you gotten a positive result from a COVID-19 test that tested saliva or use a nose or throat swab (not a blood test)?
*
No. Continue to next question
Yes. No further screening is required, you may not join class today.
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) with anyone who tested positive for COVID-19 or who has had symptoms of COVID-19?
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No. Continue to next question.
Yes. No further screening is required, you may not join class today
I wasn't absent from school today due to a class quarantine
No. You may join class today
Yes. No further screening is required, you may not join class today
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A copy of your responses will be emailed to the address you provided.
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