NESD COVID-19 FORM 12/23/20-1/12/20 (CONFIDENTIAL)
Please complete this COVID form over the winter break if your child is being tested for COVID, your child tests positive for COVID, a household contact is being tested for COVID, a household contact tested positive for COVID, a child was notified of the need to quarantine, or you believe that your child/children may have been a close contact of an individual who tested positive for COVID.
Only the Pandemic Coordinators have access to this form.
* Required
LAST NAME
*
Your answer
FIRST NAME
*
Your answer
PHONE NUMBER
*
Your answer
EMAIL
Your answer
PLEASE INDICATE THE REASON THAT YOU ARE FILLING OUT THIS FORM
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My child is being tested for COVID19.
My child tested positive for COVID19.
A household contact of my child is being tested for COVID19.
A household contact of my child tested positive for COVID19.
My child was notified of the need to quarantine due to exposure with someone who tested positive for COVID19.
I believe that my child was a close contact of an individual who tested positive for COVID19.
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