This tool will help you perform a self-assesment to determine if you are clear to report to our campus.
-You MUST answer the questions truthfully. Ohio schools are required to collect and report accurate COVID-19 data.
- This tool is based on CDC and ODH guidelines.
- More info:
Masks are currently required for everyone over the age of 2 in Ohio per Gov. Dewine and the Ohio Department of Health.
Ohio Order on Mask
Staff/Student First Name:
Staff/Student Last Name:
Do any of the following apply to you? (CHECK ALL THAT APPLY)
Within the past 14 days, you have been in close physical contact (6 feet or closer for at least 15 minutes) with a person who is known to have laboratory-confirmed COVID-19 or with anyone who has any symptoms consistent with COVID-19.
Within the Past 14 days, you have had laboratory-confirmed COVID-19.
You are isolating or quarantining because you may have been exposed to a person with COVID-19 or are worried that you may be sick with COVID-19.
You are currently waiting on the results of a COVID-19 test.
In the past 24 hours, have you had any of the following NEW symptoms? (CHECK ALL THAT APPLY)
Fever (100.5F/38C or above) or chills
Shortness of breath or difficulty breathing
Muscle or body aches
New loss of smell or taste
Congestion or Runny Nose
Nausea or Vomiting
I acknowledge that I have answered all questions truthfully and that I may be required to undergo additional screening prior to admittance to the facility/campus.
A copy of your responses will be emailed to the address you provided.