UPDATED September 2021 Daily Health Self-Screening Requirements
And at Home Daily Checklist  for Employees, Parents, Children  and Essential Visitors.

A1l School Employees, Parents, Children and Essential Visitors will need to complete a daily health 
self-check by answering the questions listed below and by taking their own temperatures each day 
prior to entering the school or being on the school property. A parent or guardian is responsible 
for completing the daily screening on behalf of their child(ren). Self-Screening:

Below are the updated self-screening questions that employees, parents, children and essential 
visitors are required to answer daily. If the answers are "No" to all of the fo1lowing questions, 
individuals may enter the school, if you answer yes please contact the school principal.  (If 
employees, parents, children and/or essential visitors cannot take their temperature at home, but 
answer "No" to all other questions, they may report to the school to have their temperature taken 
on-site).
a}   If you are not yet fully vaccinated, have you been in close or proximate contact  in the past 
10 days with anyone who has tested positive through -a diagnostic  test for COVID-19 or who has or 
had symptoms ofCOVID-19?

b)   Are you waiting for the results  of or have you tested positive through a diagnostic  test for 
COVID-19 in the past 10 days?

c)   Do you have at least Q!!£ of the following symptoms: cough, shortness of breath, difficulty 
breathing, new loss of taste or smell?

d)   Do you have at least any of the following symptoms: fever (over 100.0°F or subjective), 
cbiiis, rigors (shivers), muscle aches, headache, sore throat, nausea or vomiting, diarrhea, 
fatigue, congestion, runny nose?

If you answer YES to any of these questions on any given day, you or your child mav not enter the 
school buildin g. Contact a medical professional for guidance  and notify the school principal. For 
students with chronic illness,
only new symptoms or symptoms worse than  baseline should be used to fulfill symptom-based 
exclusion criteria.

Depending upon the answers to the screening questions, you or your child may need to receive 
medical clearance and a negative COVID test to return to work or school. If you or your chi"ld is 
sick with a common cold or other ailment not related to COVID-19 and has an approved alternative 
diagnoses they should stay home until symptoms subside and you or your child (ren) fever free 
without the aid of a temperature reducing drug.

International & Domestic Travel Vaccinated  & Uhvaccinated Follow CDC Guidance
htt ps://www.cdc.gov /coronavirus/2019-ncov/travelers/international-travel-durin g-covid19.html htt 
ps://www.cdc.g ov/coronavirus/2019-ncov/travelers/travel-during-covid19.html

•  "Pope Francis  has made it clear vaccinating  is morally acceptable and that we have the moral 
responsibility  to get vaccinated. Cardinal Dolan has said the same. There  is no mandate  by the 
Catholic schools in the Archdiocese of New Yorlc to be vaccinated,  unless required  by Government 
Health  Officials. Individuals ar·e free to exercise discretion."

By signing below and submitting this form, you acknowledge that you read the above will comply with 
all requirements and received the attached updated daily checklist that you will complete it each 
school day for yourself or your child (ren) for the
2021-2022 School Year.

Signature of Parent or Guardian_________________________________________________Date:______________

 Student Name ______________________________________________________________Grade:_____________