Parker Admission Visitor Health and Safety Form

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Dear Families,

In keeping with the highest regard for the health and safety of our community and guests, we ask that all individuals who visit Parker adhere to our community’s health and safety guidelines. All guests attending in-person admission programming:
• Should be symptom-free and willingly respond to health screening questions; and
• Will be required to present the following to the Admission Office in order to gain entry:
- Proof* of vaccination;
*Proof can be provided as a photo or hard copy of a vaccination card. We will need
both sides of your personal vaccination record card.
- Health Screening Form (1 per attendee)

To facilitate the check-in process, we ask that you complete the health screening questionnaire (below) and provide photo proof of vaccination to the Admission Office at admission@fwparker.org 48 hours prior to your scheduled visit to campus. Each visitor must provide proof of vaccination and the health questionnaire before entering our campus.

We are making every effort to keep everyone on campus safe from transmission and well. Once on our campus you will be required to wear a mask at all times. By entering our campus you also agree to cooperate with contact tracing should it be later requested of you or your child. We appreciate your cooperation.

If you have any questions, please contact the Admission Office. We look forward to safely welcoming you to Parker’s campus!

All the best,
The Parker Admission Team

Admission Event *

Event Date *

YYYY

Email Address *

Attendee 1 Full Name *

Attendee 2 Full Name

Additional Attendees Full Name(s)

I am experiencing the following NEW symptoms unrelated to pre-existing conditions *

Cough

Congestion or Runny Nose

Chills

Headache

Muscle Pain

Sore Throat

Loss of Taste or Smell

Digestive Problems

Shortness of Breath

Fatigue

Nausea or Vomiting

No Symptoms

Required

I have a temperature of 100 degrees Fahrenheit or higher. *

Yes

I verify that I am in compliance with the City of Chicago’s Travel Guidelines. *

City of Chicago Travel Guidelines: https://www.chicago.gov/city/en/sites/covid-19/home/emergency-travel-order.html

Yes

Someone in my household is awaiting the result of a diagnostic COVID test. *

Yes

I have been in close contact with someone diagnosed with COVID-19 within the past 10 days. *

Yes

I verify that I will comply with Parker's health and safety guidelines during my in-person visit to the school. *

Yes

I agree to notify Parker if I contract COVID within a week of my visit to campus by emailing admission@fwparker.org. *

Yes

I agree to cooperate with contact tracing should it be later requested of me by Parker. *

Yes

I verify that the information I have provided is true, complete, and correct. *

Yes

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