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NPS COVID-19 Reporting Form
Please complete this form if your student has tested POSITIVE for COVID-19. The information provided will be submitted directly to your student's school nurse.
If your student has tested positive for COVID-19, please read the DESE Protocols on the Return to School page on the Norton Public Schools Website here:
https://www.norton.k12.ma.us/families/covid-returntoschool-hub
For more information see the DESE COVID flowcharts here:
https://www.doe.mass.edu/covid19/on-desktop/flowcharts.pdf
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* Indicates required question
Email
*
Your email
Student's First Name
*
Your answer
Student's Last Name
*
Your answer
Which school does your student attend?
*
J.C. Solmonese Elementary School
L.G. Nourse Elementary School
Henri A. Yelle Elementary School
Norton Middle School
Norton High School
What grade is your student in?
Little Lancers
Kindergarten
Grade 1
Grade 2
Grade 3
Grade 4
Grade 5
Grade 6
Grade 7
Grade 8
Grade 9
Grade 10
Grade 11
Grade 12+
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What is the name of the person completing this form?
*
Your answer
What is the best number to reach you?
*
Your answer
Did your student test positive for COVID-19? If you answered NO, you do not need to complete this form.
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Yes
No
What is the last date your student attended school?
*
MM
/
DD
/
YYYY
Did your child take a PCR test and/or a Rapid test? (check all that apply)
*
PCR Test
Rapid Test
Required
What date did your student take a PCR test? (if applicable)
MM
/
DD
/
YYYY
What date did your student take a rapid test? (if applicable)
MM
/
DD
/
YYYY
Does your student have symptoms?
*
Yes
No
If your student has symptoms, what was the date of your student's first symptom?
MM
/
DD
/
YYYY
If your student has symptoms, please list the symptoms that they have.
Your answer
Is your student fully vaccinated? (Fully vaccinated is defined as two-weeks following the completion of the Pfizer or Moderna series or two-weeks following a single dose of Johnson & Johnson’s Janssen vaccine.)
*
Yes
No
Do you need someone from Norton Public Schools to contact you regarding your student's positive COVID-19 result?
*
Yes, I would like to speak to someone regarding questions I have or information I need to share.
No, I understand when my student should return to school.
Send me a copy of my responses.
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