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Covid-19 Student Reporting Form
Please fill out this form if you have a student who has tested positive for Covid-19. If you have multiple students, there is a section below for you to add siblings. Thank you!
If you are a
WSD
employee,
please click here for the Employee Reporting Form
.
Si necesita este formulario en español,
haga clic aquí
.
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* Required
Student's First and Last Name
*
Your answer
Student's date of birth
*
MM
/
DD
/
YYYY
Student's Grade
*
Choose
Preschool
Kindergarten
1st
2nd
3rd
4th
5th
6th
7th
8th
9th
10th
11th
12th
Adult
Student's School
*
Choose
Bonneville HS
Fremont HS
Roy HS
Two Rivers HS
Weber HS
Weber Innovation
North Ogden Jr
Orion Jr
Rocky Mountain Jr
Roy Jr
Sand Ridge Jr
Snowcrest Jr
South Ogden Jr
T H Bell Jr
Wahlquist Jr
A Parley Bates
Burch Creek
Country View
Farr West
Freedom
Green Acres
H Guy Child
Hooper
Kanesville
Lakeview
Lomond View
Majestic
Midland
Municipal
North Ogden Elem
North Park
Orchard Springs
Pioneer
Plain City
Riverdale
Roosevelt
Roy
Silver Ridge
Uintah
Valley Elem
Valley View
Washington Terrace
West Haven
West Weber
Canyon View
Adult Ed
Other
Date tested positive
*
MM
/
DD
/
YYYY
Date Covid-19 symptoms began (if asymptomatic, please just use test date)
*
MM
/
DD
/
YYYY
Where was your student tested?
*
Drive-through testing site
Private doctor's office
Home test
Other:
Date student last attended school
*
MM
/
DD
/
YYYY
Are there other siblings in the home that attend WSD who have also tested positive for Covid-19?
Yes
No
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