COVID Reporting
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Student/teacher first name *
Last name *
Parent name *
Grade *
Group *
Exposure location *
Date of exposure
MM
/
DD
/
YYYY
Start date of quarantine
MM
/
DD
/
YYYY
Last day of school attendance *
MM
/
DD
/
YYYY
Date of COVID test
MM
/
DD
/
YYYY
COVID Test result
Clear selection
Email *
Phone number *
Were you contacted by the health department?
Clear selection
Any other information you wish to share.
Submit
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