COVID-19 Close Contact of a Positive Case
In an effort to continue to make our schools safe during the pandemic, we ask that you fill out this form when/if your student has been identified as a close contact of a positive case. Please fill this form out as soon as possible to help us ensure that your student has what he or she needs to learn from home.
If you have multiple students who have been a close contact, please fill out multiple forms.
Student Last and First Name
Parent/Guardian Last and First Name
Parent/Guardian Contact Information
Student School Building
Cooper Early Education Center
Slate Creek Elementary
South Breeze Elementary
Walton Rural Life Center
Santa Fe 5/6 Center
Chisholm Middle School
Newton High School
Who is the person your student was in contact with that is now COVID positive? (Contact means: within 6 feet for 10 or more minutes).
Relationship of the COVID positive person to your student?
When did the COVID positive person start having symptoms?
When was your student's last contact with the COVID positive person?
If the COVID positive person lives in the same household as the student, are they able to separate? (No shared living, eating or bathroom space.)
If your student participates in an activity or athletics, which one does he or she participate in?
OPTIONAL: Is there any other information you'd like to share or that we would need to know?
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This form was created inside of Newton Public Schools.