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Covid-19 Screening Checklist

Please complete *ALL* fields.

First Name:

Last Name:

Email Address:

Reason for Visit:

The following are questions about new respiratory symptoms that you are experiencing today

1. Do you have a Fever?
   

(A Fever is a temperature 100.4 or higher.)

2. Do you have a sore throat?
   

3. Do you have a cough?
   

4. Are you experiencing chills, fatigue or body aches?
   

5. Do you have a headache?
   

6. Do you have nausea, diarrhea or vomiting?
   

7. Do you have a runny nose or stuffy nose?
   

8. Do you have a recent loss of taste or smell?
   

9. Do you have difficulty breathing?
   

If you have answered "Yes" to any of the questions above, and you cannot explain these symptoms by known allergies or non-infectious illnesses, then you cannot enter NEIT buildings for the safety of others.

Please answer the remaining question and acknowledgements

10. Have you been in contact with anyone positive with Covid-19 in the last 14 days? (* Please see Note 1 below)
   

11. Have you traveled anywhere outside the 50 United States in the past 14 days?
   

12. Have you traveled to Rhode Island from a location with a high community spread rate? (* See list in Note 2 below)
   

Note 1: Does not apply to people who come into contact with people with symptoms of COVID-19 during the course of their daily work while wearing full and appropriate personal protective equipment (PPE). For more information, click below.
https://www.cdc.gov/coronavirus/2019-ncov/hcp/guidance-risk-assesment-hcp.html

Note 2: Travel -If you are coming to Rhode Island from one of the states listed here with a positivity rate of COVID-19 5% or greater, you will have to self-quarantine for 14 days while in Rhode Island before you come to campus. If you do not self-quarantine for 14 days, you will not be allowed on campus. To discuss the details of your coursework during the quarantine period, returning students should contact their student advisor and first time students should contact the Admissions Office.

Any questions: Please email the NEIT Contact Tracing Team at NEITtracing@neit.edu

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