Please use this form to self-report symptoms, positive cases of Covid-19 or required quarantine.
Student's First Name
Student's Last Name
Turner Middle School
Turner High School
Please select the option that best describes the situation:
Student tested positive for Covid 19
Family member tested positive for Covid 19 so student is quarantined
Student was exposed to Covid 19 and was tested. Quarantined until results come back.
Student is experiencing symptoms
Someone in the household is experiencing symptoms and was tested, student quarantined until test results come back
If you selected other for the previous question, please explain
Please select symptoms from the list below:
Fever or chills
Shortness of breath
Muscle or body aches
New loss of taste or smell
Congestion or runny nose
Nausea or vomiting
Who is completing this form?
Turner School District Personnel
Best phone number and time of day to be reached by district nurse.
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This form was created inside of School District of Beloit Turner.