Daily Pre-screening COVID Questionnaire New York College of Health Professions Fall 2021
New York College of Health Professions is committed to the health and safety of the college community. As the college plans for the return to campus, a COVID-19 self-assessment tool has been created to assist you in the determination of whether or not you should be tested for COVID-19. Prior to entering the building each day, all individuals are required to complete the COVID-19 self assessment. Results of the self-assessment are sent to the college so that upon arrival, students, faculty, staff, and clinic patients will be safely admitted into the building. Those persons who do not submit the COVID-19 self-assessment will not be permitted in the building. The form is to be submitted on days when you are going to either Bellevue Hospital or Syosset.
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Email *
Location of Class/Appointment *
I am: *
Name *
In the past 10 days, have you experienced COVID-19 symptoms (fever or chills, cough, shortness of breath, or difficulty breathing, fatigue, body aches or muscle pain, headache, new loss of taste or smell, sore throat, congestion or runny nose, or nausea? *
In the past 10 days, have you had a positive COVID-19 test? *
In the past 10 days, have you traveled internationally (please see https://www.cdc.gov/coronavirus/2019-ncov/travelers/map-and-travel-notices.html for updated information)? *
In the past 10 days, have you had close contact with someone who tested positive for or have had symptoms of COVID-19? *
A copy of your responses will be emailed to the address you provided.
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