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 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 10 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.