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Navarro College - Screening Questionnaire
You must complete this form if you have tested positive for COVID-19 or if you have been exposed to someone with COVID-19.
Please select your status
Student
Faculty/Staff
Visitor
Name
First Name
Last Name
Student/Employee ID Number
Email
example@example.com
Phone Number
-
Area Code
Phone Number
Date you will be on campus
-
Month
-
Day
Year
Date
Screening Questions
Regardless of vaccination status or previous infection, exposure to someone with COVID-19 does
not
require you to isolate unless you become symptomatic. However, you should take precautions if you are exposed (wear a mask, distance from others, etc.) and get tested at least 5 full days after exposure.
If you test positive for COVID-19, then you should isolate immediately with the isolation count beginning the day your symptoms began regardless of when you tested positive. If you did not have any symptoms, the isolation count begins the day you were tested (not the day you received your positive result).
Visit the CDC website for further information regarding isolation and exposure.
https://www.cdc.gov/coronavirus/2019-ncov/your-health/isolation.html
Are you feeling sick? Based on Guidance provided by State health authorities, select "Yes" if you are experiencing new or worsening symptoms of the following: cough, shortness of breath or difficulty breathing, chills, repeated shaking with chills, muscle pain, headache, sore throat, loss of taste or smell, diarrhea, feeling feverish or a measured temperature greater than or equal to 100.4 degrees Fahrenheit. ·
Yes
No
Have you tested positive for COVID-19 or have you been exposed to someone with COVID-19? Based on guidance provided by State health authorities, select "Yes" if you came within six (6) feet of or were exposed to coughing/sneezing of someone with confirmed COVID-19.
Yes
No
Have you received all required doses for a COVID-19 vaccine?
Yes
No
Submit
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