USE THIS FORM TO REPORT ANY SENECA EAST STUDENT WHO HAS COVID-19 POSITIVE DIAGNOSIS
Seneca East is required to report all positive COVID-19 cases to the community and the county health department. The student's personally identifiable information will be shared with staff members who have a need to know, but will not be shared with the community at large. The community will be informed of a positive COVID-19 case within our student body or staff but the community will not be provided with information that would identify the student or staff member.
Name of Student who has a confirmed Positive COVID test.
Name of parent or guardian completing this form.
Please provide a phone number where you can be reached.
Please provide an email address where you can receive communication.
Have you been in contact with a County Health Department?
What is the student's county of residence?
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This form was created inside of Seneca East Local School.