Relationship to Student (Mother, Father, Guardian etc) *
Your answer
Parent Email *
Your answer
Parent Phone Number *
Your answer
Does your student ride the bus to/from school? *
If no, what form of transportation do they use?
Your answer
Did your student who tested positive for COVID-19 have symptoms or were they asymptomatic? *
If symptomatic, when did your son/daughter develop COVID-19 symptoms?
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What was the date of your child's positive test? *
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DD
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Was your son/daughter in close contact with any other students from school? This applies to contact in the 48 hours prior to him/her developing symptoms (if symptomatic), OR 48 hours prior to their positive test (if asymptomatic). *
Does your son/daughter have siblings at our school who live in the same house? *
Is your son/daughter involved in any school clubs, activities or athletic teams? *
If they attended any club, activities or athletic team event in the last 48 hours, please provide details.
Your answer
Did your son/daughter participate in any other events or activities on campus in 48 hours prior to developing symptoms? *
If Yes, please provide details:
Your answer
Did your son/daughter have a meeting with a faculty/staff member in the 48 hours prior to symptoms? This includes a counselor, teacher or an administrator. *
If Yes, please provide details:
Your answer
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