Covid-19 Self Declaration Form _ Existing Students - Atlantic Language School Galway

Covid-19 Self-Declaration Form_ Students in Ireland

To help prevent the spread of COVID-19 in the school, every student must complete and sign a COVID-19 Self-Declaration Form before returning to face-to-face classes at school. On review of the form, management may contact you to ask you not to start school immediately, and in this case, will discuss a suitable alternative date for your start.

Please note that you must continue all government guidance and restrictions relating to Covid-19. You must restrict your movements if you have been in close contact with a confirmed, positive COVID-19 case or if you live with someone who has symptoms of COVID-19.

Have you travelled outside Ireland in the last 14 days? *

Do you have symptoms of Covid-19 now or have you had symptoms in the past 14 days? (Symptoms of Covid-19 are: cough, fever, high temperature, sore throat, runny nose, breathlessness or flu like symptoms) *

Yes

Have you been diagnosed with a confirmed or suspected COVID-19 infection in the last 14 days? *

Yes

Are you a close contact of a person who is a confirmed case of COVID-19 in the past 14 days? *

Yes

Have you been advised by a doctor to self-isolate at this time? *

Yes