COVID-19 Symptom Screener for HIWP Minyan at TIC

  • Please fill out this form no more than 48 hours before you visit TIC.
    Please take care in answering the symptom screening questions. The purpose of the symptom screening is to ensure the safety of you and our community.

  • Date Format: MM slash DD slash YYYY
  • Symptoms:

    • Shortness of breath or difficulty breathing
    • Fatigue
    • Muscle or body aches
    • Headache
    • New loss of taste or smell
    • Sore throat
    • Congestion or runny nose
    • Nausea or vomiting
    • Diarrhea
  • All travelers entering New York from a state that is not a contiguous state, or from a CDC Level 2 or 3 Travel Health Notice country, shall quarantine for a period of 14 days, consistent with Department of Health regulations for quarantine, unless:
    • For travelers who traveled outside of New York for more than 24 hours, such travelers must obtain testing within 72 hours prior to arrival in New York, AND
    • Such travelers must, upon arrival in New York, quarantine according to Department of Health guidelines, for a minimum of three days, measured from time of arrival, and on day 4 may seek a diagnostic test to exit quarantine.

    For travelers that meet the criteria above, the traveler may exit quarantine upon receipt of the second negative test result.