KES After Hours COVID-19 Reporting
Are you a parent reporting for your child or a teacher reporting for yourself? *
Required
Are you reporting that you are positive or a close contact? *
Required
Grade *
Required
Legal Last Name *
Legal First Name *
Birthdate *
MM
/
DD
/
YYYY
Phone number where you may be reached (with area code). *
Email Address *
Reported symptoms *
Required
When did the Symptom Begin?
MM
/
DD
/
YYYY
When did you test Positive?
MM
/
DD
/
YYYY
Where did you get tested?
Please list the name(s) and school(s) below for any other children residing in the home that attend Richland Two Schools?
Please list the name(s) and school(s) below for any other Adults residing in the home that Work in Richland Two Schools?
Is your child a Car Rider?
Is your child a Bus Rider? *
Required
Is your child in aftercare at the school?
Clear selection
Is your child involved in any after-school sponsored activities, e.g. sports, band, JROTC, clubs, etc.?
Clear selection
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