Confirmed Positive COVID-19 Submission Form
For Students & Staff of OGISD
First Name *
Last Name *
Student or Staff *
Student ID
Student Date of Birth
MM
/
DD
/
YYYY
Campus/Grade Level *
Contact Phone Number *
Date of COVID-19 Positive Test *
MM
/
DD
/
YYYY
Symptom Onset Date *
MM
/
DD
/
YYYY
Last Day on Campus *
MM
/
DD
/
YYYY
Student's Siblings/Staff Member children's names and their grade levels. N/A if not applicable. *
Submit
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