*1.This is to. confirm that you are indeed reporting a postive COVID-19 case to the Ardsley school district.  If you answer "No", please do not complete the survey.(Required.)

Yes

No

*2.The positive COVID individual is(Required.)

a student at Concord Road School (CRS)

an employee at CRS

a student at Ardsley Middle School

an employee at AMS

a student at Ardsley High School

an employee at AHS

an employee at Central Office or a District Employee

an employee or Ardsley student associated with the Ardsley School District

*3.First Name of Individual(Required.)

*4.Last Name of Individual(Required.)

*5.Date of Birth (DOB) of individual(Required.)

*6.When was the test taken (Date and Approx. Time) (Required.)

7.Was there any symptoms of COVID at all leading up to taking the COVID test? 

Yes

No

Unsure/Somewhat

8.If Yes or Unsure/Somewhat in Q8 please further explain:

9.Are there any symptoms of illness now? 

Yes

No

10.Can you please share the individual's vaccination status? 

Not vaccinated

One vaccination shot

Two Vaccination shots

Two vaccination shots and a Booster

*11.What was the last date on the Ardsley campus(Required.)

12.PLEASE TAKE TIME TO READ THE FOLLWING AND ACT ACCORDINGLY.

1) Basic Directions for A Positive Individual:
A) Initially isolate the positive individual.
B) Consider when symptoms occurred or the positive test was taken. C) Then look back 48 hours from whichever happened first. ie symptoms on a Sun. at 10 am and tested pos. later on in the day. Look back from Sun. at 10 am to Sat and Friday. 
D) Inform anyone with no mask who was within 6' for 15 mins or longer during that window of contagion. Note - Unvaccinated or vaccinated individuals would monitor, should test, and if no symptoms mask and monitor. At present, for a positive COVID-19 test there is a 5-day isolation/quarantine period based on the above with a return to school on day 6 - if no symptoms mask-wearing is highly recommended through day 10.

2) AFTER YOU SUBMIT THIS SURVEY YOU WILL RECEIVE A REPLY EMAIL with phone numbers  -You can call and leave a voice message for the nurses that they'll access at work. If you need more immediate guidance call, Superintendent Schoenfeld (914) 355-1576. This will allow us to act quickly and support you and your family during this time.

3) OPTIONAL - Add any additional pertinent information below. Thank you for completing this survey. The information will be CONFIDENTIAL and only used to assist the Westchester Department of Health in their and our contact tracing efforts.