FY 21 COVID Travel Notification
All employees are expected to report their out of state travel and complete this survey. The health of our school communities relies on your following the travel protocols put in place by Executive Order for Vermont. Vermonters must follow travel restrictions and quarantine requirements for Vermont and the states they plan to visit.

If you plan to travel to Vermont by public transportation (plane, train, bus), you must quarantine in Vermont. If you are fully vaccinated, and it has been 14 days since you got your final vaccine dose, and have no covid symptoms, you do not need to quarantine. If you are not considered fully vaccinated, you must obtain a PCR test on or after Day 3 after your return to Vermont.

Per the Vermont AOE, "staff who arrive from out-of-state must follow appropriate guidance under the current step of the Vermont Forward Plan. Please reference the Vermont Department of Health’s COVID-19 travel page for updated information."

Sign in to Google to save your progress. Learn more
Email *
What exact CITY AND STATE are you traveling TO? *
What is your full name? *
Have you already received two doses of a COVID-19 vaccine? *
If you have ALREADY received two doses of a COVID-19 vaccine, what was the date you received the second dose?
What dates did (will) you travel? *
What date did you return to Vermont? *
What mode of transportation did you use? *
What was the purpose of your travel? *
Please explain reason for choosing "other" if that was your reason for travel.
Have you had close contact with or cared for someone diagnosed with COVID-19 within the last 14 days? *
Have you experienced any cold or flu-like symptoms in the last 14 days (to include fever, cough, sore throat, respiratory illness, difficulty breathing, nausea or vomiting)? *
Clear form
Never submit passwords through Google Forms.
This form was created inside of South Burlington School District. Report Abuse