Attestation for Return to School Following Illness
Student's Name *
School *
My child was sent home from or denied entry to school or childcare because of failing the COVID-19 School Screening on
MM
/
DD
/
YYYY
I attest that my child may return to school or childcare on *
MM
/
DD
/
YYYY
I attest that my child may return to school or childcare for the following reason (CHECK ONE)
My Child had only one symptom that has resolved within a 24 hour observation period AND he/she passed the COVID-19 Screening Tool for Children in School and Child Care
Clear selection
My child WAS tested for COVID 19
Clear selection
My child was NOT tested for COVID-19:
Clear selection
Parent/Guardian Name *
By clicking here, you agree this information is correct to the best of your knowledge *
Submit
Never submit passwords through Google Forms.
This form was created inside of Bruce-Grey Catholic District School Board. Report Abuse