COVID-19 Symptom Screener for HIWP Minyan at TIC

All visitors must bring and wear a face mask the entire time in the building.

Current public health guidelines advise older adults, immunocompromised individuals, and people with  underlying medical conditions to take extra precautions, as they are likely at higher risk to develop severe illness from COVID-19. People in these categories should talk to their healthcare provider to assess their risk and to determine if they should attend services in person.

If you are subject to quarantine for any reason or if you have a pending COVID test due to COVID exposure, we ask that you please stay home, even if you are asymptomatic.

Please keep coats, raincoats, and umbrellas with you. The coat room will be closed.

  • 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 your safety and the safety of our community.

  • MM slash DD slash YYYY
  • Symptoms:

    • Cough
    • Fever
    • 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
    • Gastrointestinal symptoms
  • New York State and the CDC continue to recommend quarantine for unvaccinated, asymptomatic domestic and international travelers. Recommended quarantine period after arrival in New York State is 7 days with a laboratory confirmed COVID-19 test administered 3-5 days after arrival, or 10 days without a test.