Sharon Springs CSD's COVID 19 Questionnaire for Entry Into the Building
New York State (NYS) requires public schools to screen individuals who seek entry into the school building for COVID-19 symptoms/risk before the individual can enter the school building. This must be done each time an individual seeks entry into the building.
This screening questionnaire is not a medical diagnosis of COVID-19. You are not being advised whether to
consult a health care provider or to seek COVID-19 testing. Results are solely to determine whether or not you are allowed entry into the Sharon Springs Central School building.
Sharon Springs CSD's administration is taking extensive precautions to ensure your health information is kept private.
Provide your first and last name.
Have you tested positive for COVID-19 within the last 14 days?
Have you traveled to the restricted areas according to the NYS Department of Health (
) in the last 14 days?
Have you experienced any cold or flu-like symptoms (fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and/or diarrhea) in the last 14 days?
To the best of your knowledge, have you had close contact with or cared for someone who displayed symptoms consistent with COVID-19 or who was diagnosed with COVID-19 within the last 14 days?
A copy of your responses will be emailed to the address you provided.
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This form was created inside of Sharon Springs Central School District.