Confirmed COVID-19 Case Reporting
Please fill out the form below to report a confirmed COVID-19 case. If reporting more then one case, please complete the form separately for each individual case.

All fields are required except for the date symptoms started.
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Email *
Student /Student's Family Member/Staff Name Testing Positive *
School or School Location *
Grade or School Position *
Last Date Present in Building *
MM
/
DD
/
YYYY
Date Symptoms Started (if applicable)
MM
/
DD
/
YYYY
Date Positive Test was Taken *
MM
/
DD
/
YYYY
Reporter's Name *
Telephone Number to Reach Reporter *
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