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#Protect the Nest Fall 2021 COVID-19 Attestation

Please carefully read the information and sign below.

As an incoming student for Fall 2021 at SUNY Brockport, I agree to the following:

1. Upon arrival to campus for the semester, I will follow SUNY Brockport guidance to prevent the transmission of COVID-19 (see the Bringing Back Brockport website) and monitor my health daily for any symptoms of COVID-19 as listed below:

• Body aches
• Chills
• Cough
• Fever over 100F
• Headache
• Nausea, vomiting or diarrhea
• New loss of taste or smell
• Runny or stuffy nose
• Severe fatigue
• Sore throat
• Trouble breathing

2. If I develop any of these symptoms, I will self-isolate and contact Hazen or my Primary Care Provider as soon as possible to have my symptoms evaluated. I will not come to class/campus until I am cleared.

3. If I am diagnosed with COVID-19, I will isolate per the current county guidelines and notify Hazen of this diagnosis. I will not come to campus/class until I am cleared.

4. If I am exposed to COVID-19, I will quarantine per the current county guidelines and will notify Hazen of this exposure. I will not come to campus/class until I am cleared.

  • Draw or Type
    I understand this is a legal representation of my signature. Clear
  • Name Name *
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