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Veritas Prep COVID-19 Reporting
Please use this form to report any positive cases of COVID-19 or close contacts for your students.
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* Indicates required question
Student First Name (Nombre del estudiante):
*
Your answer
Student Last Name (Apellido del estudiante):
*
Your answer
Student DOB (Fecha de nacimiento del estudiante):
*
MM
/
DD
/
YYYY
Name of Person Filling out Form (Nombre de la persona que llena el formulario):
*
Your answer
Relation to Student (Relación con el estudiante):
*
Your answer
Email (Correo electrónico):
Your answer
Phone Number (Número de teléfono):
Your answer
Which of the following applies to your student? (¿Cuál de los siguientes le aplica a su estudiante?)
*
My student tested positive for COVID-19. (Mi estudiante dio positivo a COVID-19.)
My student is a close contact to someone that tested positive for COVID. (Mi estudiante es un contacto cercano con alguien que dio positivo por COVID.)
I have a question about my students current symptoms or return date. (Tengo preguntas sobre los síntomas actuales de mis estudiantes o la fecha de regreso.)
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