ISD624 COVID-19 Diagnosis Reporting Form
Please let us know through this form if you have been diagnosed with COVID-19. Please also call your school’s attendance line (for students) or submit an absence in Skyward (for staff) if you have been diagnosed with COVID-19.
VERSIÓN en ESPAÑOL: https://docs.google.com/forms/d/e/1FAIpQLSfBOlY29qfG282z3aL0Y21Toierw0zPaAx4dg-t65yrviaEDA/viewform?gxids=7628

Sign in to Google to save your progress. Learn more
The person who received the diagnosis is: *
What school building do you (or the person) primarily go to or work in? *
Your (or the person being reported about's) name? *
Your phone number *
Your email address *
When did symptoms begin? *
MM
/
DD
/
YYYY
Date of test *
MM
/
DD
/
YYYY
What type of test was used?
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of ISD624. Report Abuse