Last updated 9/11/21

COVID-19 SYMPTOM SELF-ATTESTATION FOR ON-CAMPUS GUESTS

Criteria for presenting to Eastside Academy campus:

Since my last visit to an EA facility, I have not experienced any of the following symptoms that I cannot attribute to a previous health condition:

  • New cough
  • New shortness of breath or difficulty breathing
  • Fever over 100.4
  • Chills 
  • Muscle pain 
  • Headache 
  • Sore throat
  • Loss of taste or smell
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

And:
  • I have not been in close contact (spent over 15 minutes within 6 feet) with any person in the last 14 days who has been diagnosed with active COVID-19.

And:
  • I have not tested positive for the SARS COV2 virus (or been diagnosed with COViD-19), or if I have, then I have not exhibited any COVID-19 symptoms for at least 14 days and a medical provider has determined I no longer need to be isolated.

Call Health Services at 206-477-8000 or your primary care provider if you have any questions about the above criteria.



I understand that if I have symptoms, have tested positive, or have known sick contacts or exposures as described above, or if I choose not to complete this form, I will not meet criteria for being present on campus.

I understand that this attestation is recorded as criteria for visiting campus (met or not met) and is logged by name and date and screening result only, no health information is recorded.

Recommendations:

If you have one or more of the above symptoms, or if you have a close contact diagnosed with COVID-19:
  • You must stay home and not come to campus.
  • If you develop any of the above symptoms while on campus – you will be asked to go home, avoid contact with others and take care of yourself.
  • Report symptoms and known contacts confidentially to King County Health Department (employees, students, and visitors) at 206-477-8000.
  • Contact your health care provider for medical guidance.