COVID-19 Screening - The Toronto Heschel School

Please complete the screening below regarding your health in order to determine if you can visit the school today.

Name*

First Last

Email*

Phone*

1. I confirm that I have been fully vaccinated against COVID-19*

Yes

2. Do you have any of the following NEW or WORSENING symptoms?*

Yes

Fever over 37.8°C
Cough
Difficulty Breathing
Loss of taste or smell
Feeling unwell, muscle aches or tired
Nausea, vomiting or diarrhea

*If mild headache, tiredness, sore muscles or joints occur within 48 hours after getting a COVID-19 vaccine, select "No" and wear a medical mask when at school. If symptoms last longer than 48 hours or worsen, select "Yes".

3. Does anyone in your household have one or more of the above symptoms and/or is waiting for test results after experiencing symptoms?*

Yes

*If you are fully vaccinated, or have tested positive for COVID-19 in the last 90 days and been cleared select "No"

4. Have you travelled outside of Canada in the past 14 days?*

Yes

*If fully vaccinated, select "No."

5. Has anyone in your household been notified as a close contact of someone with COVID-19 or been told to stay home and self-isolate?*

Yes

*If you are fully vaccinated and you do not have to self-isolate, select "No."

6. In the last 10 days, have you tested positive on a rapid antigen test or a home-based self-testing kit?*

Yes

*If you have since tested negative on a lab-based PCR test, select "No."

Signature*