Covid-19 Self-Reporting Form (Palm Beach Gardens Campus)
This form is to be used by Franklin Academy staff, parents, students, vendors, volunteers and other community members. Self-isolation would be associated with exposure to someone with actual COVID-19 or having a positive test result. This information is needed to provide support to you or a student under your care, during self-isolation and to monitor the potential presence of COVID-19 in the schools. This information will not be used for any punitive or other negative consequences.
You will receive customized questions after indicating the person's role at Franklin. Thank you for completing this form.
Responses to this survey are considered educational records with regards to students and employment records with regards to employees and are subject to all applicable privacy statutes, regulations and guidance including FERPA, IDEA and HIPPA.