STAFF COVID-19 HEALTH SCREENING
                                                                COVID-19 DAILY HEALTH SCREENING FORM
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Are you experiencing any symptoms of COVID-19? This includes a fever of 100+*F, cough, loss of taste or smell, sore throat, severe headache, diarrhea/vomiting, or shortness of breath. - Answer “No” if: --- Ongoing symptoms were cleared by a medical professional or local public health official --- OR if you received a negative PCR or rapid diagnostic lab test --- OR if you received two negative results from at-home tests taken at least 24 hours apart since the onset of symptoms AND have only mild symptoms (no runny nose; if cough, cough minimal and non-productive; fever-free for 24 hours without the use of medication)Have you been diagnosed with COVID-19 within the last 10 days AND have not completed your required quarantine? - Answer “No” if you tested positive within the past 10 days AND completed isolation for a minimum of 5 days after your positive test results or symptoms began, whichever came first.If you are not fully vaccinated: Have you been exposed to an individual who tested positive to COVID-19 AND have not completed your required quarantine? - Answer “No” if you were exposed to COVID-19 within the past 10 days AND completed quarantine for a minimum of 5 days after the last day of exposure.<NEW YORK Scholars and Staff ONLY> Within the past 10 days, have you been exposed to an individual at school who tested positive to COVID-19 AND have not completed Test To Stay requirements? - Answer “No” if you completed diagnostic test(s) as directed by your school and have NOT received a positive result.If you answered YES to any of the above, you must mark off “Yes” below and you must stay home. If you answered NO to all questions above, mark off “No”. *
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