Is your child fully vaccinated? (Fully vaccinated means 2 doses -- if the student is 18 and the 2 doses were over 5 months ago then a booster is also needed) *
Did your student test positive for COVID in the last 90 days? *
What date did your student test positive?
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What was the last day your student was in school?
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Are you waiting on a COVID test or do you plan to have your student take a COVID test soon?
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Was your student a close contact of someone who tested positive within the last 10 days? (A close contact is being within 6 feet for 15 minutes or more to someone who tested positive -- 3 feet if student to student) *
If yes, please list the date of the close contact
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Does the close contact live with you?
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What is the reason you are calling in for your student? Please check all that apply. *
Required
Date the symptoms started *
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Is there a chronic condition or reason for the symptoms? Please give short explanation
Your answer
Parent name *
Your answer
Parent email *
Your answer
Parent phone number *
Your answer
Does your student have siblings in the district? (We only use this if we need to contact trace) *
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