JNPSD COVID-19 Reporting Documentation 22-23
Staff or Students please complete this report for testing positive for COVID-19 or if you have been exposed by a person who has tested positive. An email with dates for the quarantine will be sent to you.
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Last Name *
First Name *
Select One *
Is this staff member or student being reported experiencing symptoms today? *
Date of Birth *
MM
/
DD
/
YYYY
Name of Student's Guardian
Guardian or Staff Contact Number *
Staff or Parent/Guardian's email address *
Staff Only - Position in the District
Building Assignment *
Required
Check  the report you are making. *
Does the POSITIVE individual who exposed staff or student live in the home? *
What testing method was used? *
If staff or student has been exposed, is it possible to isolate from the positive individual?
Clear selection
If you have been exposed, what is the date of last contact with the positive individual?
MM
/
DD
/
YYYY
If tested positive, date symptoms began?
MM
/
DD
/
YYYY
Date COVID swab was collected?
MM
/
DD
/
YYYY
Last date student or staff was on a school campus? *
MM
/
DD
/
YYYY
Has the individual you are reporting been fully vaccinated (2 doses plus 1-booster)? *
Submit
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