TCCS Student Covid-19 Close Contact Report
Parents: Please complete the following information to let the school know if your student has come into close contact (within 6 ft for 15 minutes or more within a 24 hour period) with a Covid-19 positive case OUTSIDE of the school setting. Close contacts that occur within the school do not need to be reported, as we already have this information.

Once this form is submitted, someone from the school will follow up soon after to provide instructions and/or ask for additional information.

Thank you for your cooperation!
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Email *
Student Name *
Student Grade *
Date of Close Contact with a Positive Covid-19 Case *
Please advise the date that the close contact occurred.
MM
/
DD
/
YYYY
Vaccination Status *
Please advise the vaccination status of the student.
Comments (optional)
Please provide any additional comments or relevant information that you would like to share.
Person Completing Form and Relation *
Please enter the name of the person completing this form and your relation to the student.
A copy of your responses will be emailed to the address you provided.
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