COVID-19 Self-Test Kit Results
This form is to record the result of your Covid-19 Self-Test Kit.

Please ensure you provide all the correct information below.

Should you have any questions, please contact post@ccwhitby.org
Email *
Your Name (Full Name) *
Are you a Student or Staff member? *
(DoB) Date of Birth *
MM
/
DD
/
YYYY
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