BUSD Symptomatic Staff COVID-19 Case Reporting Form  - 2024-2025 and 2025-2026 School Years   

This form is only for symptomatic staff who were infectious while at a BUSD campus or district facility.  

DETERMINING YOUR INFECTIOUS PERIOD (Per CDPH)

For COVID-19 cases with symptoms: The infectious period is a minimum of 24 hours from the day of symptom onset. Once 24 hours have passed with no fever, without the use of fever-reducing medications, and symptoms are mild and improving, the infectious period has ended. 

For COVID-19 cases with no symptoms: There is no infectious period. (Please do not complete this form.)  If symptoms develop, the infectious period information in the above paragraph will apply.

When can you return to work?
Please read BUSD's 2025-2026 COVID Safety Plan for information about how you can return to work.  If you do not have symptoms, you may continue to work, following guidance in the Safety Plan. 

Note that Cal/OSHA requires staff cases to mask for 10 days after symptoms started. If the case did not have symptoms, Cal/OSHA requires they mask for ten days after the positive test date.

El Plan de Seguridad COVID 2025-2026 está disponible en español aquí.


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Today's Date
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First Name *
Last Name *
Email Address *
Last date on a BUSD campus or at a BUSD office or facility: *
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Date of Positive Test *
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Date symptoms began.  (Do not report cases without symptoms.)
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During your infectious period, please list any BUSD facilities where you were present. (See the top of this form for how to determine your infectious period.)

NOTE: If you are BAS staff, please indicate the physical locations where you were while infectious.

 *
Please select all that apply.  
Required
Please list the names of any BUSD staff close contacts you had only while infectious at work. *
Close contact: Someone sharing the same indoor airspace with a COVID-19 case during their infectious period for a cumulative total of 15 minutes or more over a 24-hour period .  

Please only write their first AND last name. Separate people with commas. (e.g. Trish McDermott, Musashi Asano)

Your Position/Job Title
Is there anything else the COVID Response Team needs to know? 
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