COVID-19 Reporting Form
Use this form to report your child's COVID-19 status
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Email *
Student's First Name: *
Student's Last Name: *
Student's Grade *
Student's Homeroom Teacher:
Has your child tested for COVID-19? *
Date of COVID-19 test:
MM
/
DD
/
YYYY
What were the results? *
Any questions or comments for school administration?
Would you like a response from the school? This response will come within 24 hours of the next school day. *
Contact information if you would like a follow-up response (Please provide your full name, phone # and email address).
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