Confirmation of positive COVID-19 Test Results
Date *
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Student Forename *
Student Surname *
Year Group *
Parent/Carer Forename *
Parent/Carer Surname *
Has your child had a positive COVID19 test result? *
What date did the symptoms start? *
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What are the symptoms? (tick all that apply) *
Required
What date was the test taken? *
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What date was the positive test result received? *
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Was your child in school on the day that symptoms first started? *
Did your child first start with symptoms on Saturday 17th October 2020? *
Did your child first start with symptoms on Sunday 18th October 2020? *
If your child's symptoms started on Saturday 17th October or Sunday 18th October, in order to assist us with our track and trace exercise, please provide details below of who your child has been in close contact with during social times (including break and lunch) over the last full two days before symptoms appeared. *
If your child's symptoms started from Monday 19th October 2020 onwards, please insert the date below
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Email address *
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