Cleared to Enter DOE Schools and Facilities

Sunday, April 3, 2022 1:12 AM (ERROR)

Please re-take daily or immediately if your symptoms change. (this badge expires at midnight)

Hello Guest

I'm a Student

I'm a Visitor or a Family Member

I’m a non-DOE Staff/Contracted Provider

First Name

What's your first name?

Last Name

What's your last name?

Please provide a valid email.

Phone

- optional

Address

Please provide a valid address.

Address 1

City

Please provide a valid city.

State New York

Please provide a valid state.

Zip Code

Please provide a valid zip code.

School or Facility You're Entering Other

Benjamin N. Cardozo High School (Q415)

Please provide location.

Floor

Hello

As of March 7, face coverings are no longer required and are optional for most students, staff, and visitors when on DOE property. Students that are at least two-years old that are enrolled in LYFE, EarlyLearn (Infants & Toddlers), 3- K, Pre-K, and 4410 classrooms, and staff in these classrooms, will continue to wear face coverings while indoors.

Individuals that are at least two-years old returning from shortened isolation or quarantine periods must wear a wellfitting face covering, such as a KN95, KF94, or a surgical mask under a cloth mask for Days 6 through 10. If the individual is unable to wear a well-fitting face covering for the duration of the school day, the individual must continue to isolate or quarantine for the full 10 days.

Are you completing this screener for a student who is younger than kindergarten age?

Yes. I am completing this screener for a LYFE, EarlyLearn (Infant &Toddler), 3-K, Pre-K of 4410 student.

No.

Has your child experienced any symptoms of COVID-19, including a fever of 100.0 degrees F or greater, a cough, sore throat, loss of taste or smell or shortness of breath that began in the last 10 days?

Yes, and they have received a negative result from a COVID-19 diagnostic test performed by a health care provider since the onset of symptoms, their symptoms are improving, and they have been fever-free for the past 24 hours without the use of fever-reducing medicine. If my child is at least two years old, they will wear a well-fitting mask through Day 10.

Yes, and they are at least two years old and received two negative results from an at-home test taken at least 24 hours apart since the onset of symptoms, their symptoms are improving, and they have been fever-free for the past 24 hours without the use of fever-reducing medicine. If my child is at least two-years old, they will wear a well-fitting mask through Day 10.

Yes, and they have had a positive diagnostic test for COVID-19, and recovered, within the past 90 days. Their recent symptoms are improving and they have been fever-free for the past 24 hours without the use of fever-reducing medicine.

Yes, and they are not in the categories above.

In the past ten days, has your child gotten a positive result from a COVID-19 diagnostic test?

Yes, and they have had a positive diagnostic test for COVID-19, and recovered, within the past 90 days.

Yes, and it has been 10 full days since their symptoms first began, their symptoms are improving, and they have been fever-free for 24 hours without the use of fever-reducing medicine.

Yes, and they are not in the categories above.

In the past ten days, to the best of your knowledge, did your child share a classroom, or come in close contact, with a person with COVID-19? “Close contact” means being less than 6 feet away for at least 15 minutes over a 24-hour period from a person who tested positive for COVID-19.

Yes, and they are at least two years old and have completed a five-day quarantine (where Day One of quarantine is the day after the last close contact to someone with COVID-19). They are symptom-free and have tested negative on Day Five of their quarantine using a diagnostic test performed by a healthcare provider OR tested negative on Days Four and Five of their quarantine using at-home tests. They will wear a well-fitting mask through Day 10.

Yes, and they are under two years old and have completed a seven-day quarantine (where Day One of quarantine is the day after the last close contact to someone with COVID-19). They are symptom-free and have tested negative on Day Five of their quarantine using a diagnostic test performed by a healthcare provider.

Yes, and they have had a positive diagnostic test for COVID-19, and recovered, within the past 90 days and have no new symptoms following their recent exposure.

Yes, and they are fully vaccinated against COVID-19.

Yes, and they are not in the categories above.

Have you experienced any symptoms of COVID-19, including a fever of 100.0 degrees F or greater, a cough, sore throat, loss of taste or smell or shortness of breath that began in the last five days?

Yes, and I have received a negative result from a COVID-19 diagnostic test performed by a health care provider. My symptoms have been improving and I have been fever-free for the past 24 hours without the use of fever-reducing medicine. I will wear a well-fitting mask through Day 10.

Yes, and I received two negative results from an at-home test taken at least 24 hours apart since the onset of symptoms. My symptoms have been improving and I have been fever-free for the past 24 hours without the use of fever-reducing medicine. I will wear a well-fitting mask through Day 10

Yes, and I am returning after isolating for five days. My symptoms are improving and I have been fever-free for 24 hours without the use of fever-reducing medicine. I will wear a well-fitting mask through Day 10.

Yes, and I had a positive diagnostic test for COVID-19, and recovered, within the past 90 days. My symptoms are improving, and I have been fever-free for the past 24 hours without the use of fever-reducing medicine.

Yes, and I am not in the categories above.

In the past five days, have you gotten a positive result from a COVID-19 diagnostic test?

Yes, and I am returning after isolating for five days from when my symptoms began or from when I was tested if asymptomatic. I am symptom-free or my symptoms are improving and I have been fever-free for 24 hours without the use of fever-reducing medicine. I will wear a well-fitting mask through Day 10.

Yes, and I had a positive diagnostic test for COVID-19, and recovered, within the past 90 days.

Yes, and I am not in the categories above.

In the past five days, to the best of your knowledge, did you share a classroom, or come in close contact, with a person with COVID-19? “Close contact” means being less than 6 feet away for at least 15 minutes over a 24-hour period from a person who tested positive for COVID-19.

Yes, and I am fully vaccinated against COVID-19.

Yes, and I was exposed at school and am taking DOE-provided COVID-19 take-home test(s) and have NOT received a positive result on those tests. I am aware that it is recommended I wear a well-fitting mask through Day 10 and if I test positive, I will begin isolation.

Yes, and I was exposed at school but I have not received a home test kit. Please contact your school to ensure you receive a home test kit today. I am aware that it is recommended I wear a well-fitting mask through Day 10, and if I test positive, I will begin isolation.

Yes, and I had a positive diagnostic test for COVID-19, and recovered, within the past 90 days and have no new symptoms following my recent exposure.

Yes, and I am not in the categories above.

This Health Screening is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Health screening results will be reviewed for the sole purpose of gaining access to facilities and confidentiality will be maintained.

COVID-19 Testing Consent

The New York City Department of Education (NYC DOE), working with NYC Health + Hospitals and the New York City Department of Health and Mental Hygiene, has partnered with laboratories and other providers to test NYC DOE students, teachers, and staff members for COVID-19 infection.

Our laboratory and provider testing partners will come to every school periodically to test a sample of the students, teachers and staff. If you consent, you may be selected for testing on one or more of these occasions, and you may also be tested in accordance with state and city mandates, or if you exhibit one or more symptoms of COVID-19, or if you are a close contact of a student, teacher, or staff person with COVID-19 infection, or in connection with your involvement in an extracurricular activity for which testing may be conducted.

If you consent, you will receive a free diagnostic test for the COVID-19 virus. Collecting a specimen for testing involves inserting a small swab, similar to a Q-Tip, into the front of the nose and/or collecting saliva.

COVID-19 test results will generally be provided within 48-72 hours. If your test results are positive, you must stay home, and should inform your supervisor and contact your doctor immediately to review the test results. If you test negative but have symptoms of COVID-19, or if you have concerns about your exposure to COVID-19, you should call your doctor. If you need help finding a doctor, call (844) NYC-4NYC.

Notification of information sharing

The law allows some information about you to be shared with and among certain New York City and New York State agencies and their contracted service providers, including those listed below. This information will be shared only for public health purposes, which include notifying your close contacts if they have been exposed to COVID-19 and taking other steps to prevent the further spread of COVID-19 in schools and communities. Information about you that may be shared with these agencies and service providers conducting COVID-19 testing includes your name and COVID-19 test results, date of birth/age, gender, race/ethnicity, school name(s), address, telephone, mobile number, and email address. Information will only be shared in accordance with the laws and City policies protecting privacy and the security of your data.

NYC Department of Education
NYC Department of Youth and Community Development
NYC Department of Health and Mental Hygiene ·
NYC Health and Hospitals Corporation
NYS Department of Health
Contracted Service Providers for COVID-19 Testing

Consent

By signing this form (including electronically signing), I attest that:

I have signed this form freely and voluntarily.
I consent to be tested for COVID-19 infection.
I understand that I may be tested at multiple times through September 30, 2022, and that testing may occur on days scheduled by the NYC DOE in accordance with the testing program or state and city mandates, or if I exhibit one or more symptoms of COVID-19, or if I am a close contact of a student, teacher, or staff person with COVID-19 infection, or in connection with my participation in an extracurricular activity for which testing may be conducted.
I understand that this consent form will be valid through September 30, 2022, unless I notify my school in writing that I revoke my consent.
I understand that my test results and other information may be disclosed as permitted by law.

Do you consent that a COVID-19 test can be administered to you?

Yes

Download a printable version of this questionnaire

Hello Guest

Hello

Original text