Health Screening
Mandatory Health Screening Questions
for Students, Staff, Vendors
Hidden
admin
Hidden
User Role
Hidden
Household
Hidden
Name
*
First
Last
Email
Hidden
Date
MM slash DD slash YYYY
Login to the Portal to access the rest of this form
Health screening for…
*
Staff
Student
Vendor/Guest
Hidden
Which Grades will you be in contact with?
*
None
Nursery 2s
Nursery 3s
PreK
Kindergarten
Kindergarten
1st Grade
2nd Grade
3rd Grade
4th Grade
5th Grade
6th Grade
7th Grade
8th Grade
Other
Select Student
*
Select
– Fill Out Other Fields –
Hidden
Student ID
Hidden
Student Grade
Hidden
Student Name Full
Hidden
Student Name
First
Last
Hidden
Status
Company if Vendor | Grade if Substitute
Vendor or Guest Name
First
Last
Vendor or Guest Email
Birthday
Month
1
2
3
4
5
6
7
8
9
10
11
12
Day
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
Year
2023
2022
2021
2020
2019
2018
2017
2016
2015
2014
2013
2012
2011
2010
2009
2008
2007
2006
2005
2004
2003
2002
2001
2000
1999
1998
1997
1996
1995
1994
1993
1992
1991
1990
1989
1988
1987
1986
1985
1984
1983
1982
1981
1980
1979
1978
1977
1976
1975
1974
1973
1972
1971
1970
1969
1968
1967
1966
1965
1964
1963
1962
1961
1960
1959
1958
1957
1956
1955
1954
1953
1952
1951
1950
1949
1948
1947
1946
1945
1944
1943
1942
1941
1940
1939
1938
1937
1936
1935
1934
1933
1932
1931
1930
1929
1928
1927
1926
1925
1924
1923
1922
1921
1920
In the past 10 days, this individual has been tested for the virus that causes COVID-19, also known as SARS-CoV-2?
*
No
Yes
Was the test result positive OR are you still waiting for the result?
*
No
Yes
Hidden
In the last 10 days has this individual traveled to a NONCONTIGUOUS state?
*
No
Yes
Hidden
How long was your visit
*
Less than 24 hours
More than 24 hours
Hidden
Have you received a Negative Covid-19 test in the four (4) days since returning to NY?
*
Yes
No
Hidden
Have you received a Negative Covid-19 test within three (3) days prior to your return to NY?
*
Yes
No
Hidden
Did you quarantine for 3 days upon returning?
*
Yes
No
Hidden
Did you receive a negative test on day 4 of your return?
*
Yes
No
In the last 14 days, has this individual been designated in contact of a person who tested positive for COVID-19 by a local health department?
*
No
Yes
Does this individual currently have (or has had in the last 10 days) one or more of these new or worsening symptoms?
*
A temperature
greater than or
equal to 100.0° F
Feel feverish
or have chills
Cough
Loss of taste
or smell
Fatigue/feeling
of tiredness
Sore throat
Shortness of breath
or trouble breathing
Nausea, vomiting, diarrhea
Muscle pain
or body aches
Headaches
Nasal congestion/runny nose
No Symptoms
Hidden
Symptom Total
Hidden
In School Temperature Check
Not taken
Normal
Has Temperature
Today is Tuesday
Jun 28, 2022
Visit our Covid-19 Dashboard
login
Login Help
Visit the Main High Meadow Site
Menu
login
Login Help
Visit the Main High Meadow Site
Logout
Email Address
Password
Remember Me
Log In
Lost your password?
-- OR -- Login using your gmail account below ---
Connect with
Login with Google
Hidden
User Role
HMS Upper School Technology Agreements
School provided technology equipment:
Students at High Meadow School are provided access to technology equipment to enhance their learning experience. Inappropriate use can result in the school experiencing interruption in learning, virus attacks, compromised systems and information as well as other liabilities. It is important for all students using technology to adhere to the guidelines set forth and use the technology accordingly and appropriately.
High Meadow School provides technology and internet access for academic use only. Use of such technology is a privilege. Therefore access to technology and the internet may be suspended, disabled or revoked if abused. All users have the responsibility to utilize the technology and internet in an efficient, ethical and lawful manner. Upon discovery of any violation the Technology Department may discover, we reserve the right to limit or suspend the students' access immediately.
To utilize the provided equipment, all students and/or guardians must sign and return this form. We ask that you review our guidelines with your child before signing and submitting this form.
By signing this document, you agree to accept the use of technology provided by High Meadow School following the guidelines outlined below:
Follow internet safety practices. Do not reveal any personal/private information about yourself or others and report any threatening or inappropriate communications directed to you. Do not communicate with people you do not know online.
Use appropriate language at all times. Do not deliberately access or transmit inappropriate images or language through provided devices. Keep all use of technology equipment and language respectful and appropriate at all times.
Respect all law and copyright restrictions and do not use High Meadow Technology equipment for anything other than its intended purposes.
Do not create, download or distribute inappropriate material, computer viruses or other destructive programs/apps that may or may not harm the property of yours or anothers school equipment.
Do not download any additional software onto a school provided device or modify any of the existing software. All devices are equipped with all the software necessary for student use.
Do not modify or reconfigure the hardware, software or operating system on the provided devices. Treat all equipment with care as to not damage any of the devices, or equipment in any way.
Do not share provided equipment with another classmate or family member. Each piece of technology assigned to the student is their responsibility.
Any extended device brought in from home must be approved by the Technology Department before it is connected (either hardwired or wirelessly) to a school provided device.
Do not share passwords or account information that is specific to you under any circumstances unless required by the technology department.
Personal device usage on school grounds:
Students must understand that all teachers, assistant teachers, assistants and supervising adults are in positions of authority and that any reasonable instruction given while school is in session must be followed. These agreements are subject to change; parents and students will be notified regarding any changes.
Students at High Meadow School will adhere to the following guidelines regarding their own personal technology devices while on school grounds:
Leave phones or any personal technology devices (i.e.: iPads, iPods, phones, tablets etc.) at home or in their lockers (when provided) or backpacks with the power and/or ringer off.
Personal laptops are not permitted
All students will be assigned an HMS device for use in school
Check-in points will be allowed at specified times throughout the day as needed or approved by a faculty/staff member. Computers and phones are only to be used with adult permission and supervision during school hours.
What is appropriate personal device/Internet usage when approved by a faculty/staff member?
Educational content, Reading, Music, Trivia apps
Limitations on personal device/Internet Usage
Video games, Social media (also, photos taken at HMS may not be posted on social media)
Using other people’s online accounts or devices
Unkind or discriminatory communication, harassment, threats or bullying of any form through devices or while using the internet
Searching for or visiting sites that include discriminatory, violent, or sexually explicit content
Any student engaging in the behaviors underlined above will immediately lose access to
classroom computer & google account, pending a parent meeting.
Students must understand that all teachers, assistants and supervising adults are in positions of authority and that any reasonable instruction given while school is in session must be followed.
These agreements are subject to change. Parents and students will be updated regarding any changes.
I have read and agree to abide by the above guidelines :
Hidden
Household
Parent/Guardian Name
First
Last
Signature
Student Name
First
Last
Signature