COVID-19 STUDENT ILLNESS REPORT
The Ohio Department of Health has issued an order that requires all Ohio school districts to report confirmed cases of COVID-19.
Deer Park Community City Schools asks that parents notify the District, either by filling out this form or calling us if their child either is exhibiting symptoms of COVID-19, has been tested for COVID-19 or has received a positive COVID-19 test.
This secure form is submitted directly to school nurses and district administrators for review. You will receive a follow-up phone call from our District within 24 hours (or by Monday if reported over the weekend).
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Student's first and last name:
Parent's first and last name:
What is a good phone number to reach you?
School student attends:
Deer Park Jr/Sr High School
Deer Park Discovery (Holmes)
What symptoms does the student have?
Fever >100 degrees
Shortness of breath
Loss of taste or smell
What date did the student's symptoms begin?
Has the student been tested for COVID-19?
If no to above question, do you plan to have your student tested for COVID-19?
Has the student received a positive COVID-19 test result?
What date did the student receive a COVID-19 test?
Has your student been exposed to a positive case of COVID-19 in the past 14 days?
Please list any siblings the student has in the district along with their grade level(s).
Anything else you would like to share?
IF YOUR CHILD IS ILL, DO NOT SEND THEM TO SCHOOL
Report your child's absence to your child's school. Absences must be reported prior to the start of the school day.
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This form was created inside of Deer Park Community City School District.