APS COVID-19 Staff Self-Report Form
Use this form to report positive COVID-19 tests, COVID-19 symptoms after a recent exposure to Health Services. COVID-19 exposure without symptoms do not need to be reported.

The self-report form is primarily intended to get case information to nurses and principals quickly and does not replace compliance with existing HR reporting protocols.
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Email *
Contact Information
If you are filling this out on behalf of someone else, please use their information below.
Name: *
Last name, First name
Phone number: *
Please enter the best phone number to contact you.
APS/work e-mail address: *
Please use your @atlanta.k12.ga.us or school-assigned email address
Alternate e-mail address:
If you would like to receive follow-up communications related to this report at another email address
Best contact method for follow-up: *
Select at least one.
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