COVID-19 Screening Survey

As we continue to adapt to the COVID-19 pandemic, the health and safety of our school district community remains our top priority.

To ensure the health and safety of our school district community, it is paramount that authorized personnel at Hastings-on-Hudson UFSD receive the most accurate health-related information from our employees and families.

In order to facilitate this process, we kindly ask for you to fill out these COVID-19 Screening Questions as accurately as possible.

Once you complete the questions, please click "Submit" at the bottom.

*Contact Type:

Contact ID:

(optional)

*First Name:

*Last Name:

*Phone Number:

*Email:

*Confirmation Email:

*School:

Do you have any of the following symptoms:

Fever of 100.0 or more 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
Diarrhea

Have you tested positive for COVID-19 or have had any COVID-19 symptoms in the last 14 days?

Have you been in close contact with a confirmed or suspected COVID-19 case in the last 14 days?

Have you traveled internationally or to any state that will require you to quarantine, in the last 14 days?

Are you experiencing any of the symptoms or scenarios above? NoYes