Positive COVID Student Report
Please complete this form if your child attends Calhoun City Schools and has tested positive for COVID-19 beginning 12/18/20 through 1/6/21. Someone will be in contact with you prior to January 6.
Email address *
Student's First and Last Name *
Student Grade *
Student's Address *
Date COVID Related Symptoms Started *
MM
/
DD
/
YYYY
Date Student Tested Positive for COVID *
MM
/
DD
/
YYYY
COVID Testing Location *
Does Student currently participate in any school extracurricular activities?
If possible, please list any other students or staff your child feels like has been a close contact (within 6 feet for more than 15 minutes) since 2 days before his/her symptoms started. *If you are able to notify any of your close contacts, please feel free to do that. *
Parent First and Last Name *
Parent Contact Number *
Submit
Never submit passwords through Google Forms.
This form was created inside of Calhoun City Schools. Report Abuse