Visiting NYSS Required Survey

Before making your way to the New York Studio School, we require that you complete this survey each day prior to entering the building. Thank you for helping to bolster the health and safety of our community. Your responses will be used for admittance to the building and for any potential contact tracing only and for no other purposes.

All NYSS COVID-19 related policies and procedures remain in effect, and apply equally to all persons entering the building.

Name*
First Last
Email*
Phone*
I will be coming to NYSS today as a:*
In the past 10 days, have you had any signs or symptoms of possible COVID-19, such as:*
Cough*
Shortness of breath or difficulty breathing*
Feeling feverish or a measured temperature => 100⁰ Fahrenheit
Chills
Muscle pain
Sore throat
New loss of taste or smell
Diarrhea
Headache*
*without known non-contagious or chronic cause
- Yes
- No
In the past 10 days, have you received a lab-confirmed COVID-19 positive result?*
- Yes
- No
In the past 10 days, have you had known close contact with a person who is lab-confirmed to have COVID-19, and/or has symptoms consistent (as listed above) with COVID-19? (Please note: Close contact is defined as being 6 feet or closer for 15 minutes or more total over a 24 hour period. If you have received a negative test result 5 days post-exposure and do not have any symptoms, you may answer “No” to this question).*
- Yes
- No
Are you currently required to quarantine in New York State?*
Quarantine guidelines for travelers to New York State have recently changed, and will be subject to change in the future. If you have recently traveled out of New York State, you must refer to the currently posted guidelines in the New York State COVID-19 Travel Advisory before answering this question. The New York State COVID-19 Travel Advisory is at the following link: https://coronavirus.health.ny.gov/covid-19-travel-advisory
- Yes
- No
Consent*
I hereby certify that, if applicable due to travel out of New York State, I have read and understand the guidelines in the New York State COVID-19 Travel Advisory.
I hereby certify that all of the information I am submitting is true, complete, and accurate to the best of my knowledge.
Phone
This field is for validation purposes and should be left unchanged.

Visiting NYSS Required Survey

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