Reason for use: The health questionnaire is presented in order to ensure a safe environment in schools and school facilities in order to ensure the safety and health of students, thus maintaining full-time in person form teaching and minimizing the risk of its interruption. In the case of a student/employee of the university, the university may process personal data from this questionnaire on the basis of Art. 6 par. 1 letter e) and Art. 9 par. 2 letter c), g), i) of the GDPR Directive to the extent specified here, in order to ensure the protection of the health of students and staff, including a safe and hygienic environment. Name Surname E-mail Phone Year of Study ---1ˢᵗ Year of Study2ⁿᵈ Year of Study3ʳᵈ Year of Study4ᵗʰ Year of Study5ᵗʰ Year of Study6ᵗʰ Year of Study Study Programme ---Animal ScienceGeneral Veterinary MedicinePharmacyPostgraduate study (PhD.) AIS ID    1. I declare that I have been fully vaccinated1 against COVID-19 and have the appropriate confirmation of this ---Yes, I amNo, I am not If I have not been vaccinated against COVID-19, I plan to get vaccinated in future: ---YesI am considering this optionNo Type (name) of vaccine: ---Single-dose vaccineFirst dose of a two-dose vaccineBoth doses of a two-dose vaccineThird dose of a vaccine Date of vaccination with the 3rd dose: (resp. the second for a single dose of the first vaccine) Date of vaccination with the 1st dose: Date of vaccination with the 2nd dose: Date of vaccination with the 1st dose: Date of vaccination: 2. I declare that in the last 180 days I have overcome COVID-19 confirmed by a RT-PCR test and I have the appropriate confirmation of this ---Yes, I have overcome COVID-19No, I have not overcome COVID-19 Date of the test: 3. I declare that I have been abroad in the last 14 days and I have fulfilled the obligations of home isolation, including persons living in the same household, after entering the territory of the Slovak Republic for 14 days, or I have received a negative PCR test result after the 5th day of home isolation, or I have a status of a fully vaccinated person1 ---Yes, I have been abroad and fulfilled the obligationsNo, I have not been abroad Instruction: In case of manifestation of symptoms (rhinitis, cough, body temperature above 37.5 °C, loss of smell and taste, diarrhea, headache) in you or persons living in the same household and relations, you are obliged to contact a general practitioner immediately, proceed in accordance with his/her recommendations and not to enter the university premises until a time determined by the relevant doctor. I further declare that I am not showing symptoms of an acute illness, that the Regional Public Health Authority has not ordered me a quarantine measure (quarantine, increased health surveillance or medical supervision). I do not know that I, my family or other persons living with me in the same household, as well as other relations, have come into contact during the last month² with people who have contracted a communicable disease (e.g. COVID-19, diarrhea, viral hepatitis, meningitis, fever with rash). I am aware that in the event of a change in my health or the manifestation of symptoms of a disease, I must report this immediately and I cannot attend the university. I am aware of the legal consequences if this statement is not true. 1 A fully vaccinated person shall be considered: a) a person at least 14 days but not more than 12 months after administration of the second dose of COVID-19 vaccine with a double-dose scheme, b) a person at least 21 days but not more than 12 months after administration of the first dose of COVID-19 vaccine with a single-dose scheme, c) a person at least 14 days but not more than 12 months after administration of the first dose of COVID-19 vaccine, if the first dose was given within 180 days of overcoming COVID-19. 2 A close contact shall be normally considered a person who has had personal contact with a COVID-19 case within two meters for more than 15 minutes, or physical contact with a COVID-19 case, or unprotected direct contact with a COVID-19 case in a closed environment for more than 15 minutes – a close contact is not considered a person, who is not considered a close contact in the sense of the definition of the currently valid Decree of the Public Health Authority of the Slovak Republic, sucha s a person fully vaccinated or a person who has overcome COVID-19. INSTRUCTIONS FOR STUDENTS on behaviour during the winter semester of the academic year 2021/2022 during the COVID-19 pandemic I undertake that: 1. If I am not fully vaccinated or have not overcome COVID-19 in the last 180 days, I will only participate in attendance (in person) form of teaching with a valid negative PCR or Ag test according to the OTP protocol in accordance with the current COVID automaton and regulations of the Public Health Authority of the Slovak Republic and I will provide a confirmation upon request. 2. I will not participate in attendance (in person) form of teaching, field trips, clinical practice, etc. if I have a temperature higher than 37.5 °C and/or symptoms of a respiratory disease. I will immediately inform the university by telephone or e-mail about non-participation in classes. 3. I will immediately inform the university by e-mail or telephone about the suspicion of COVID-19 and/or contraction of COVID-19. 4. I will immediately inform the university by e-mail or telephone in the event that the Regional Public Health Authority orders me a quarantine measure (quarantine, increased health surveillance or medical supervision). 5. I will limit mutual contact with students of other years of study, study programmes and other universities. 6. During the teaching process and inside the indoor premises of UVMP, including accommodation, I will comply with all current anti-epidemic measures and measures for the obligation to cover the upper airways as specified by the Decree of the Public Health Authority of the Slovak Republic. 7. During field trips, in clinical practice, etc. I will comply with current anti-epidemic regulations and measures of the Decree of the Public Health Authority of the Slovak Republic, instructions of the university and other instructions of third contacting parties (e.g. slaughterhouse, etc.). 8. In order to maintain public health, I will behave responsibly in the following period, refrain from risky activities, and follow other operating instructions of UVMP in Košice published on its website and/or at it premises, as well as other hygienic and preventive measures valid in the Slovak Republic. 9. Throughout the academic year 2021/2022, I will act in accordance with these Instructions. I hereby confirm that I have read the Instructions and that I will abide by them.