WCSD COVID-19 Reporting Form
The Wickliffe City School District is providing this reporting form in compliance with the Ohio Director of Health's September 3, 2020 order, which requires school districts: "To facilitate timely contact tracing and prevent further transmission of COVID-19, all schools that provide any kindergarten through grade twelve instruction shall maintain a reporting system for parents to report positive tests and/or cases of COVID-19."

The Director's order can be found here: https://coronavirus.ohio.gov/wps/portal/gov/covid-19/home

Please complete this form if you are the parent or guardian of a Wickliffe City School District student who has tested positive for COVID-19. The District will follow confidential reporting procedures in required reporting to health agencies.

Last name of the student who has tested positive for COVID-19. *
First name of the student who has tested positive for COVID-19. *
Grade level of the above-listed student. *
Date of positive COVID-19 test result. *
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Name of the person completing this form. *
Relationship of the reporting adult to the above-named student. *
Phone Number of reporting adult *
Email address of reporting adult *
Other information
Please provide any other information you feel is relevant about this student, illness, or situation.
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