COVID-19 Self-Reporting Form
Please use this form to self report any confirmed cases of the coronavirus in your family.
Email *
Have you, your student, or an immediate family member received a positive COVID 19 test? *
Required
What is your first name? *
What is your last name? *
If you are a DCI parent/guardian, please list the name of the DCI student: *
What is the best number to reach you? *
What is your relationship to DCI? *
Notes:
Submit
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