Daily Covid Questionnaire

In response to the COVID-19 Corona Virus concerns, please use the following questions to help us prevent potential virus exposure in our community.

Student Firstrequired

Student Lastrequired

Who are you answering for today?*

Myself My child My student (guardian/faculty)

Have you or anyone in your household confirmed positive for COVID-19 in the last 30 days?*

Yes No

If you have answered yes to any of the screening questions or no to any of our safety questions you cannot come into Newman until you have been symptom free for 72 hours, you agree to follow our safety protocols and you have completed this screening form again. Please contact Newman home office 617-267-4530 immediately to discuss your school attendance plan.

Are you awaiting the results of a test for Covid-19 that you sought as a result of exposure to the virus or experiencing symptoms? (Does not apply to those being routinely tested for work/research)*

Yes No

If you have answered yes to any of the screening questions or no to any of our safety questions you cannot come into Newman until you have been symptom free for 72 hours, you agree to follow our safety protocols and you have completed this screening form again. Please contact Newman home office 617-267-4530 immediately to discuss your school attendance plan.

Have you been asked to self-isolate or quarantine by your doctor or a public health official and still within the required 14 day quarantine period?*

Yes No

If you have answered yes to any of the screening questions or no to any of our safety questions you cannot come into Newman until you have been symptom free for 72 hours, you agree to follow our safety protocols and you have completed this screening form again. Please contact Newman home office 617-267-4530 immediately to discuss your school attendance plan.

Do you have COVID-19 symptoms: headache, new loss of taste/smell, sore throat, congestion/runny nose, nausea/vomiting, diarrhea?*

Yes No

If you have answered yes to any of the screening questions or no to any of our safety questions you cannot come into Newman until you have been symptom free for 72 hours, you agree to follow our safety protocols and you have completed this screening form again. Please contact Newman home office 617-267-4530 immediately to discuss your school attendance plan.

Are you traveling/returning to MA from areas outside New England, New York or New Jersey, and/or have you been on an airplane or on a cruise in the past 14 days?*

Yes No

If you have answered yes to any of the screening questions or no to any of our safety questions you cannot come into Newman until you have been symptom free for 72 hours, you agree to follow our safety protocols and you have completed this screening form again. Please contact Newman home office 617-267-4530 immediately to discuss your school attendance plan.

I agree to participate in the Newman COVID-19 Safety Protocolsincluding wearing a mask or face covering, maintaining a 6-foot distance from others, and cleaning my desk before and after use.*

Yes No

Newman School's protocols must be adhered to if you going to be in the building. If you are not comfortable with all aspects of the protocol, please take advantage of our on-line option. Please notify the Chandra in the Front Office immediately at 617-267-4530 at csingaram@newmanboston.org.

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Daily Covid Questionnaire

How are you feeling today?

It's a great day to be a Cardinal!!