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NEWTON NORTH HIGH SCHOOL COVID-19 VISITOR QUESTIONAIREPlease check “YES” or “NO”COVID-19 SELF ASSESSMENT CHECKLISTYESNODo I have a fever (100F or higher), chills, shaking chills?Do I have a cough? (not due to other known cause, such as chronic cough)Do I have difficulty breathing or shortness of breath?Do I have new loss of taste or smell?Do I have a sore throat?Do I have a headache? (when in combination with other symptoms)Do I have muscle aches or body aches?Do I have nausea, vomiting or diarrhea?Am I experiencing fatigue? (when in combination with other symptoms)Do I have nasal congestion or a runny nose (not due to other known causes, such as allergies and when in combination with other symptoms)Have you/your child been told by a public health official to isolate or quarantine??In the last 14 days, have you/your child traveled anywhere that isn’t on the Massachusetts?list of lower-risk states?and do not have a valid negative PCR test (no longer than 72 hours before returning or after your arrival)??Signature Date________________________________________ _________________If you answered “YES” to any of these questions, STAY HOME and contact your healthcare provider.Where can I get tested for COVID-19?Contact your healthcare provider if you think you need to be tested. The Massachusetts Department of Public Health maintains a map of testing locations and information here. If you need a COVID-19 test and you are unable to obtain one, please call the Newton HHS department at 617-796-1420. ................
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