Staff Mandatory Reporting Form: COVID-19 Illness/Exposure/Testing Reporting Form
NOTE: This is NOT the DAILY building entry form. Staff is NO LONGER REQUIRED to complete the building entry form.

This COVID-19 form is intended ONLY for staff experiencing symptoms of COVID-19, who have been exposed to a confirmed positive case of COVID-19, or who are testing for COVID-19. Enter the below information following the employee's self-report.
Sign in to Google to save your progress. Learn more
Email *
Employee Name *
Date of Birth *
Employee School/Department *
Employee Telephone Number *
Please use format "XXX-XXX-XXXX"
Employee Position
Clear form
Never submit passwords through Google Forms.
This form was created inside of Hamilton County Schools. Report Abuse