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Daily Attestation of Health for Students at Holy Trinity Diocesan High School.
This form must be filled out and submitted by 7:45 AM on each school day by parents on behalf of their child(ren) who are attending in-person classes at Holy Trinity Diocesan High School. If you answer "yes" to any question, it is advised that your child not attend school today. Please note that if your child has traveled outside of New York State, they must follow the quarantine and testing protocols as established by the Department of Health.
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* Indicates required question
Email
*
Your email
Today's Date
*
MM
/
DD
/
YYYY
Your Name
*
Your answer
Relationship to Student
*
Parent
Legal Guardian
Other:
Student Last Name
*
Your answer
Student First Name
*
Your answer
Student ID Number
*
Your answer
Student Grade
*
9th Grade
10th Grade
11th Grade
12th Grade
Does your child have a temperature greater than 100⁰F?
*
Yes
No
Has your child come into sustained close and proximate contact (within six feet for at least 15 minutes) of someone who has a laboratory confirmed COVID-19 diagnosis within the past 14 days?
*
Yes
No
Does your child have any of the following: fever or chills, cough, shortness of breath or difficulty breathing, body aches, headache, new loss of taste or smell, sore throat?
*
Yes
No
A copy of your responses will be emailed to the address you provided.
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