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RHI COVID-19 Prerequisite Screening
Please complete this screening form before arriving on site at the RHI building or Red Hook Farms
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Name
*
Your answer
Phone Number
Your answer
Department, or Volunteer?
Choose
Volunteer
Admin
Development
Farm
Community Building
Young Adult
High School
Middle School
Counseling
Operations
NYU
Other
Are you fully vaccinated?
*
No
Yes
Have you experienced a fever of 100.4 degrees Fahrenheit or greater, a new cough, sore throat, runny nose, fatigue, or shortness of breath within the past 10 days? (If you answered YES please stay home)
*
No
Yes
To the best of your knowledge, in the past 5 days, have you been in close contact (within 6 feet for at least 10 minutes) with anyone while they had COVID-19? (If you answered YES please stay home)
*
No
Yes
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