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RCSD employees and families are being asked to complete the health self-assessment checklist form each day before coming to work. Upon entering into the building each day please completed form below. In the interest of keeping our RCSD family healthy and safe, it is imperative we all do our part!
If you answer yes to any of the symptoms below, it is strongly recommended that you contact your medical provider for further guidance.
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Contact Type:
Select Contact Type
Student
Employee
Other
Contact ID:
(optional)
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First Name:
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Last Name:
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Best Contact Number:
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Email:
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Confirm Email:
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School/Grade:
Select a School
Central Office Staff-Only
Midland School Staff-Only
Midland School Kindergarten
Midland School 1st Grade
Midland School 2nd Grade
Midland School 3rd Grade
Midland School 4th Grade
Midland School 5th Grade
Milton School Staff-Only
Milton School Kindergarten
Milton School 1st Grade
Milton School 2nd Grade
Milton School 3rd Grade
Milton School 4th Grade
Milton School 5th Grade
Milton School Spec.Edu(13)
Osborn School Staff-Only
Osborn School Kindergarten
Osborn School 1st Grade
Osborn School 2nd Grade
Osborn School 3rd Grade
Osborn School 4th Grade
Osborn School 5th Grade
Osborn School Spec.Edu(13)
PUPIL PERSONNEL SERVICES Staff-Only
Rye High School Staff-Only
Rye High School 9th Grade
Rye High School 10th Grade
Rye High School 11th Grade
Rye High School 12th Grade
Rye Middle School Staff-Only
Rye Middle School 6th Grade
Rye Middle School 7th Grade
Rye Middle School 8th Grade
Visitor / Contractor
No
Yes
Have you had a positive result from a COVID-19 viral test within the past 14 days? If yes, please contact RCSD Health Services.
No
Yes
Have you come into contact with a person who has had a positive result from a COVID-19 viral test within the past 48 hours?
No
Yes
Is your temperature currently 100.0 *F (38.0*C) or higher?
No
Yes
Are you currently taking fever reducing medication (Motrin, Tylenol, Advil, etc)?
No
Yes
Have you traveled internationally, thereby requiring a 10-day quarantine?
No
Yes
Are you awaiting the results of a Covid-19 test?
Since the last time you reported to school, have you had any of the following symptoms?
Fever of 100.0 F (38 C) or above, or possible fever symptoms like alternating chills and sweating
Congestion or runny nose
Cough
Fatigue
Sore throat
Headache
Trouble breathing, shortness of breath or severe wheezing
Chills or repeated shaking with chills
Muscle aches
Loss of smell or taste, or a change in taste
Nausea, vomiting or diarrhea
No
Yes
Do you have any of the above symptoms?
I have read the employee self-health assessment checklist and know the contents thereof; that the same is true to my knowledge and have given the answers set forth above knowing that the Rye City School District will rely upon them in determining admission into the building.