Lakeside Health Services- COVID-19 Support
Please complete this form to report a positive COVID-19 case
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Preferred Parent/Guardian Email Address *
First Name of Student *
First name of student impacted by COVID
Last Name of Student *
Last name of student impacted by COVID
Please provide a phone number where you can be reached during the school day, including area code *
Grade Level of Student *
Parent/Guardian First Name *
Parent/Guardian Last Name *
Does your child have a sibling at Lakeside Middle School? *
What are you reporting? *
How is your student impacted by COVID
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