Veritas Prep COVID-19 Reporting
Please use this form to report any positive cases of COVID-19 or close contacts for your students.
Sign in to Google to save your progress. Learn more
Student First Name (Nombre del estudiante): *
Student Last Name (Apellido del estudiante): *
Student DOB (Fecha de nacimiento del estudiante): *
Name of Person Filling out Form (Nombre de la persona que llena el formulario): *
Relation to Student (Relación con el estudiante): *
Email (Correo electrónico):
Phone Number (Número de teléfono):
Which of the following applies to your student? (¿Cuál de los siguientes le aplica a su estudiante?) *
Clear form
Never submit passwords through Google Forms.
This form was created inside of Veritas Preparatory Charter School. Report Abuse