Fillable Visitor Attestation Regarding COVID-19 (Anne Arundel Community College)

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Visitor Attestation Regarding COVID-19 (Anne Arundel Community College)

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Updated October 28, 2020
Visitor Attestation Regarding COVID-19
To protect the safety and public health of the AACC campus and community, Anne Arundel
Community College (“AACC” or “College”) requires that visitors, including guests, volunteers,
invitees, and other participants in a College-sponsored program or activity, sign and return this
attestation to be present on property owned, leased or operated by the College (“Campus”).
By signing below, I attest to the following:
• I am not currently experiencing and have not experienced any of the following symptoms
for the last ten (10) days: (1) fever or chills; (2) cough; (3) shortness of breath or difficulty
breathing; (4) fatigue; (5) muscle or body aches; headache; (6) new loss of taste or smell;
(7) sore throat; (8) congestion or runny nose; (9) nausea or vomiting; (10) diarrhea; or
(11) any other COVID-19 symptom identified by a federal or Maryland public health
agency (“Symptoms”).
• I have not had a positive COVID-19 test result on a test that was within the last fourteen
(14) days. A COVID-19 test means an FDA Emergency Use Authorized COVID-19
molecular assay for detection of SARS-CoV-2 RNA or other test approved by CDC or FDA
(“test”).
• I am not aware of having been exposed to a person with a suspected or confirmed COVID-19
case. For purposes of attesting to this paragraph, exposure means having an intimate
partner, housemate or giving care to a person who has a suspected or confirmed case of
COVID-19.
o Suspected case means experiencing or having experienced symptoms within the
last ten (10) days and includes the 48 hours prior to the person experiencing
symptoms.
o Confirmed case means had a positive test result on a COVID test that was
conducted within the last fourteen (14) days.
• If I am on Campus at any point and I am not able to confirm that the above statements are
true, I will immediately leave Campus and will submit a report to COVIDsafety@aacc.edu
immediately.
• By being present on Campus, I am attesting that all of the above-statements are true.
• I will wear a cloth face mask at all times when on Campus and acknowledge that I am not
permitted to be on Campus without wearing an appropriate face mask.
• I will practice social distancing (i.e. remain 6 ft apart from others) to the greatest extent
possible while on Campus.
• I will comply with all applicable Executive Orders by federal, State and local governments and
will stay apprised of other directives, advisories, such as travel advisories, and guidance from
federal, State, and local public health agencies and health departments.
• I will comply with all protocols, directives, policies, procedures, guidelines or guidance
provided by AACC related to COVID-19, which may be more restrictive the government
orders.
• I acknowledge and agree that if I experience symptoms, have a positive test result or have
been exposed to a person with a suspected or confirmed case of COVID-19:
1. I will notify the College immediately by emailing COVIDsafety@aacc.edu.
2. I will respond to requests for information from the appropriate local health
department and AACC regarding my circumstances related to COVID-19.
3. I will provide an email address to the College and will monitor that email address for
information regarding my circumstances related to COVID-19.
4. I will follow the CDC and appropriate local health department guidance for isolation or
quarantine.
5. If requested by AACC, I will provide AACC with a copy of negative test result, a letter or
email from a State or local health department or health care provider that states that I
may discontinue isolation or quarantine, a further attestation on a form provided by
AACC or any other documentation requested by AACC by submitting such
documentation to COVIDsafety@aacc.edu
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Visitor Attestation Regarding COVID-19 (Anne Arundel Community College)

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Completed 28 January 2021

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