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Health Screening Questionnaire

Fifth Avenue Synagogue continues to monitor the evolving COVID-19 pandemic closely, particularly as it pertains to the Delta variant. We are working with medical experts to ensure the safety of our members and visitors. FAS requires that masks are worn by all those attending services or classes in the building.
Thank you!


You may not attend if you have any of these conditions:

Cough - Shortness of breath or difficulty breathing
Chills - Repeated shaking with chills
Muscle pain
Headache
Sore throat
Loss of taste or smell
Diarrhea and fever
Feeling feverish or a measured temperature greater than or equal to 100.0 degrees Fahrenheit
Known close contact with a person who is lab confirmed to have COVID-19 or in contact with someone being tested for COVID -19 within 14 days from the last exposure.


Thank you.
Mon, December 6 2021 2 Teves 5782