Report COVID-Positive Test Result
Please use this form is to report a positive test result of a BISD staff or student.
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Patient Name (First, Last)
*
Patient's Date of Birth
*
MM
/
DD
/
YYYY
Is the COVID-positive individual a student or a BISD staff member? *
Parent/Guardian Email (for a student case) Staff Email (for a staff case)
*
Phone Number
*
Parent/Guardian First and Last Name (if applicable)
When did the patient test positive for COVID?
*
MM
/
DD
/
YYYY
School/Building
*
Is the patient experiencing any of the following symptoms (check all that apply)
If symptomatic, date of symptom onset
MM
/
DD
/
YYYY
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