2023-24 Student COVID Case Report Form 
Hello,

Use this form to report a student case of COVID-19. 

The form will provide the earliest date your student may return to school and other information. 

Please be sure to contact your school office to let them know of your student's absence and return date.   

Updated 10/2023

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First & last name of person filling out this form *
Best email address and phone number for reaching the person filling out this form: *
The next several questions refer to the individual who tested positive for COVID-19.
First and last name: *
Grade *
Which school does your student attend?  *
Teacher's name (preschool and elementary only)
Is the student participating in an athletic team, extracurricular activity, or before/after care at AAPS?  If yes, list it here. If no, type "no." *
Date symptoms first started: (If no symptoms, enter 01/01/0001). *
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Date tested for COVID-19. *
MM
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DD
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YYYY
Date last on school grounds: *
MM
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DD
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WHEN TO RETURN TO ACTIVITIES AFTER TESTING POSITIVE 
Please read carefully
Individuals who test positive must isolate at home for a minimum of 5 days. 

How to count isolation days: 
Day zero = day symptoms began (or if no symptoms, the day of the COVID test). On day 5, if your student is fever-free for 24 hours, without fever-reducing medication, and symptoms are greatly improved or gone, your student may return to school on day 6. They must wear a well-fitting mask on days 6-10 (see next question).

We strongly recommend testing on day 5. Stay home until testing negative, or until day 10. You may return to school on day 11. 

Based on the information above on how to count isolation days, what is your student's earliest possible date to return to school? 
 *
MM
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DD
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YYYY
Students who return from isolation on days 6-10 are STRONGLY URGED to wear a tight fitting mask indoors. A multilayer surgical, KN95 or N95 indoors is best.
Do you have any questions or concerns? Please list them here. 
Thank you for reporting this COVID case, and we hope that your student feels better soon!  Please read What to Do If You Test Positive for additional guidance. 

Be sure to report your student's absence and return date to the school office.

Questions? Contact your school nurse or principal.

Resource: CDC If You Are Sick or Caring for Someone

You may also want to follow up with your health care provider, or visit the Washtenaw County Health Department's COVID website for more information about taking care of a sick family member and other COVID information. https://washtenaw.org/coronavirus
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