Overseas Travel and Self-Quarantine Status Update for YIS Health Office

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Complete this form ONLY IF you have travelled outside Japan during or after the Spring Break.

We are asking anyone who has travelled overseas to self-quarantine at home upon return to Japan for at least 14 days before returning to school once the campus is reopened. This applies even if only one member of your household has been overseas. Self-quarantine means staying in your home with only people who usually live in the household (i.e., no visitors) and avoiding close contact with others when you do go outside for fresh air and exercise or if you have to pick up necessities. See the COVID-19 Community Support FAQ for further guidance. Please use this form to let us know your current status, as well as any questions you may have. The information that you provide in this form is shared only with senior leadership and the school nurse and will be treated in strict confidence. Thank you for your understanding and cooperation in helping to protect the health of our school community.

Family name *

Name(s) and grade(s) of child(ren) at YIS. *

Contact email *

Contact telephone

For families who were overseas earlier and have now returned to Japan

When did you return to Japan?

YYYY

In which country or countries were you staying?

Upon returning to Japan have you and your child(ren) maintained self-quarantine for 14 days?

Yes, it has already been 14 days

Yes, we have maintained self-quarantine since returning and intend to continue for a total of 14 days

No, we have not maintained self-quarantine since returning but will do so from now on

Other:

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For families who are still overseas

In which country are you currently staying?

When is your intended date of return to Japan?

YYYY

Upon returning to Japan the school asks that you and your child(ren) maintain self-quarantine for 14 days before they may return to school. What is the last date of your self-quarantine period?

YYYY

For all families

Has any member of your family experienced flu-like symptoms during or since your overseas stay? *

Yes

If yes, please provide details such as the extent and type of symptoms and whether you have consulted a medical professional or not.

Do you have any questions or other pertinent information to share with us at this time?

Submit

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